JOB SUMMARY

Responsible for working cross-functionally to support the organization in obtaining and maintaining NCQA Health Plan accreditation. This position uses knowledge of current NCQA Health Plan standards to work effectively with 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.

JOB SPECIFICATIONS

Serve as a resource to business owners; responsible for maintaining current knowledge of NCQA Health Plan Standards, and ensuring the organization is up to date with current requirements.
Maintain accurate and up to date timelines and progress reports to assure the project stays on target and all milestones are met. Ensures management is updated and is notified as areas of risk/barriers are identified. Coordinates with accreditation consultants and the assigned project manager
Conduct mock audits of the various areas within the scope of accreditation providing business owners with a written summary of the findings.
Maintain minutes of all accreditation committee meetings and support management in preparing for meetings including presentations, agendas and resource materials.
Coordinate cross functional workgroups within the organization to support accreditation efforts, including scheduling and facilitation. Maintain workgroup notes and update project plan activities.
Other duties may be assigned

Reports to Position Title: Sr, Manager NCQA Accreditation

QUALIFICATIONS:

Education/Specialized Training/Licensure: Bachelor's degree in business, Social Work, Health Care, Project Management or related field required

Masters preferred

Work Experience (Years and Area): 5 years of managed care with proven experience required.

Experience with NCQA Health Plan standards preferred

Quality Improvement or Project Management experience is preferred

Software Proficiencies: Microsoft Office (Word, Excel, PowerPoint, Outlook)

Other: Must be able to establish and maintain collaborative working relationships across the organization to meet accreditation standards

Able to communicate with business owners in ways to gain buy-in and support meeting accreditation standards.

Able to effectively and efficiently keep management updated and able to identify barriers and risks related to accreditation.

Proficient in annotating and uploading documents to the NCQA portal.