NCQA Quality & Accreditation Specialist
Alliance Health
full-time
Posted on:
Location Type: Remote
Location: North Carolina • United States
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Salary
💰 $68,227 - $86,990 per year
About the role
- Serve as the project management lead and subject matter expert for assigned NCQA standard areas
- Manage the assessment of related business functions for corresponding departments within the scope of NCQA standards
- Support high-quality performance and ensure successful NCQA Accreditation process
- Support the Continuous Quality Improvement Committee
- Implement and Monitor Accreditation Workplan
- Identify gaps and risks and provide regular status reports from NCQA tracker to leadership
- Serve as lead for NCQA Accreditation reviews for assigned standard categories
- Review and update policies and procedures, reports, materials, and files for completeness, accuracy, and compliance with NCQA Standards
- Maintain calendar of documentation due dates
- Participate in Delegation Oversight and audits as appropriate
- Provide technical support and education to staff regarding NCQA Health Plan Accreditation
- Assess business area functions against current and upcoming NCQA standards
- Coordinate and collaborate with cross-departmental teams to identify and implement organization-wide strategic initiatives that support quality performance
Requirements
- Bachelor’s degree in Healthcare, Human Services, Public Health Administration, Nursing, Business, or related field
- Three (3) years of project management experience in a managed care or healthcare setting with knowledge and practical experience health care quality or NCQA Health Plan accreditation processes and requirements
- Experience with NCQA Accreditation standards.
- Knowledge of regulatory reporting, compliance requirements, and auditing procedures.
- Project management.
- Knowledge of NCQA accreditation processes and standards
- Knowledge and understanding of federal and state regulations
- Planning, project management and organizational skills
- Excellent communication skills (written and verbal).
- Effective, respectful, and sensitive interpersonal skills to a diverse and multicultural population of children, families, and co-workers
- Problem-solving, mediation, and conflict resolution skills
- Teamwork and collaboration skills
- Microsoft Project, Excel, Word (Edits and Tracking), and PowerPoint skills
- Facilitation skills
Benefits
- Medical, Dental, Vision, Life, Long Term Disability
- Generous retirement savings plan
- Flexible work schedules including hybrid/remote options
- Paid time off including vacation, sick leave, holiday, management leave
- Dress flexibility
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
project managementNCQA accreditationregulatory reportingcompliance requirementsauditing procedureshealthcare qualityplanningproblem-solvingmediationconflict resolution
Soft Skills
communication skillsinterpersonal skillsteamworkcollaborationorganizational skillsfacilitation skills