Senior Accreditation Specialist
Centene Corporation, Florida, NY, United States
Position Purpose
Serves as a SME regarding accreditation standards and continuous quality improvement principles. Coordinates and performs accreditation oversight and survey readiness. Serves as a lead communicator with health plan and department senior leadership.
Responsibilities
Develop and coordinate delegation oversight mechanisms for complex plans (multiple products, large populations, known gaps, critical time frame for achieving accreditation, etc.)
Conduct file review, identify gaps, communicate results and perform re‑audits as required; review and update tools, process documentation and policies related to accreditation.
Develop and maintain accreditation readiness schedule.
Create policy and procedures to support accreditation activities.
Provide training on complex issues affecting identified NCQA file elements, including creating appropriate training materials and supporting improvement activity carried out either at the health plans or on a corporate basis.
Develop QI, NCQA and HEDIS projects with delegated vendors to support accreditation maintenance and HEDIS reporting.
Coordinate assigned NCQA and HEDIS work plan activities.
Education/Experience
Bachelor’s degree in Business, related field or equivalent experience. 4+ years of related accreditation, quality improvement, HEDIS and/or NCQA experience.
License/Certification
CPHQ certification preferred; Licensed healthcare professional preferred.
Pay Range
$70,100.00 - $126,200.00 per year.
Benefits
Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job‑related factors permitted by law, including full‑time or part‑time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Equal Opportunity Employer
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
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Serves as a SME regarding accreditation standards and continuous quality improvement principles. Coordinates and performs accreditation oversight and survey readiness. Serves as a lead communicator with health plan and department senior leadership.
Responsibilities
Develop and coordinate delegation oversight mechanisms for complex plans (multiple products, large populations, known gaps, critical time frame for achieving accreditation, etc.)
Conduct file review, identify gaps, communicate results and perform re‑audits as required; review and update tools, process documentation and policies related to accreditation.
Develop and maintain accreditation readiness schedule.
Create policy and procedures to support accreditation activities.
Provide training on complex issues affecting identified NCQA file elements, including creating appropriate training materials and supporting improvement activity carried out either at the health plans or on a corporate basis.
Develop QI, NCQA and HEDIS projects with delegated vendors to support accreditation maintenance and HEDIS reporting.
Coordinate assigned NCQA and HEDIS work plan activities.
Education/Experience
Bachelor’s degree in Business, related field or equivalent experience. 4+ years of related accreditation, quality improvement, HEDIS and/or NCQA experience.
License/Certification
CPHQ certification preferred; Licensed healthcare professional preferred.
Pay Range
$70,100.00 - $126,200.00 per year.
Benefits
Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job‑related factors permitted by law, including full‑time or part‑time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Equal Opportunity Employer
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
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