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Accreditation Quality Manager

Tacoma, Washington Apply Now Job ID 1150304 Category Compliance Organization Coordinated Care Schedule Full-time
Description:

Position Purpose: Ensure compliance with accreditation requirements and conduct routine readiness assessment and evaluation of policies and procedures, processed and records


  • Oversee the health plan NCQA preparations for accreditation surveys
  • Actively participate in the preparation of accreditation documents
  • Schedule and manage documentation submission and onsite audits
  • Utilize the Interactive Review Tool (IRT) to manage the NCQA Accreditation and Certification survey process
  • Maintain continuous, up to date knowledge of NCQA Accreditation process
  • Educate the health plans on NCQA requirements and/or Center for Medicare/Medicaid Services (CMS) standards and requirements
  • Evaluate compliance of the corporations Medicare plans with NCQA
  • Health Plan and SNP standards and reporting requirements
  • Lead policy and procedure documentation reviews for the health plans based on NCQA standards
  • Develop readiness assessment schedules, conduct accreditation audits and ensure changes to the standards are incorporated
  • Oversee the development of organization wide initiatives to support accreditation
  • Maintain work processes to meet the latest NCQA/URAC accreditation standards
  • Assist with training and education development to promote accreditation standards

Qualifications:


Education/Experience: Bachelor’s degree in Nursing, Healthcare Administration, related field or equivalent experience. 4+ years of quality improvement, regulatory compliance and/or auditing experience. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

License/Certification: Current state nursing license RN, LPN or LVN preferred. Valid driver’s license.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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