Job Summary:
The Enterprise Accreditation Specialist II is responsible for being the subject matter expert for select NCQA accreditation standards, analysis, and readiness across all lines of business. Works cross-functionally to support the organization in obtaining and maintaining NCQA accreditation. This position uses knowledge of current select NCQA standards to work effectively with selected business owners to identify gaps and deficiencies between current processes and the requirements of accreditation standards, and to assist in implementation of any necessary changes as needed. Ensure all changes made by NCQA are communicated and incorporated into business processes.
Essential Functions:
- Serve as subject matter expert for select NCQA standards
- Acquire an in-depth knowledge of select standards within the scope of work and ensure that changes made by NCQA are communicated and incorporated into business processes
- Ability to establish and maintain collaborative working relationships with select business owners to meet accreditation standards
- Develop a strong understanding of the business processes within the assigned business areas
- Collaborate with select business owners to obtain documents, reports, and materials for accreditation submission
- Review and analyze documents, reports, and materials for submission. Ensures accuracy prior to submission
- Communicates with business owners on necessary revisions to documents, reports and materials
- Monitor, track, and document deliverables related to accreditation process by applying accreditation standards to CareSource processes and documents in conjunction with the business owners
- Responsible for preparing materials including but not limited to updating and reformatting for submission to accrediting entities in accordance with standards, coordinating efforts with business owners, and tracking readiness against work plans and timelines
- Update accreditation Market specific roadmaps and communicate identified risks or noncompliance to Accreditation Specialist and Management
- Work collaboratively with Accreditation Specialist or Management to assist and support management and resolution of identified noncompliance concerns
- Follow up on potential and identified risks or noncompliance from meetings with business owners
- Maintain state of readiness for accreditation by assisting team with accreditation assessments to determine compliance with specified standards and identify improvement opportunities
- Collaborate with other Accreditation Specialists for consistency
- Perform a variety of complex work in planning, coordinating, and managing accreditation activates
- Provides education to business owners on accreditation standards and provide timely updates to affected departments including accreditation activities, survey dates and timelines for deliverables
- Provide management recommendations for improvement related to accreditation processes and document processes
- Manages Accreditation SharePoint site
- Manage multiple projects with competing priorities and deadlines
- Participate in applicable committees as required
- Perform any other job duties as assigned
Education and Experience:
- Bachelor’s degree in science, arts, healthcare or other related field or equivalent years of relevant work experience is required
- Minimum of two (2) years of experience in a Managed Care Organization or other healthcare related field is preferred
- Accreditation experience is preferred
Competencies, Knowledge and Skills:
- Familiarity with accreditation bodies
- Interpersonal skills and high level of professionalism
- Critical thinking/listening skills
- Problem-solving skills with strong attention to detail
- Ability to work independently and within a team environment
- Ability to develop, prioritize and accomplish goals
- Ability to coordinator complex projects and multiple meetings
- Proficient in Microsoft Office Suite to include Word, Excel, Adobe Pro and SharePoint
- Excellent written and verbal communication skills
- Familiarity of the healthcare field and with Marketplace, Medicaid, and Medicare
- Training/teaching skills and technical writing skills
Licensure and Certification:
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$53,400.00 - $85,600.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
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