Accreditation Compliance Specialist
2 months ago
Transform the health of our communities, one person at a time, as a key member of our team at Centene Corporation.
Position Purpose:Ensure compliance with accreditation requirements and conduct routine readiness assessments and evaluations of policies and procedures, processes, and records.
- Oversee the health plan's NCQA preparations for accreditation surveys.
- Educate the health plans on NCQA and/or CMS standards and requirements.
- Evaluate compliance of the corporation's 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.
Bachelor's degree in Nursing, Healthcare Administration, or 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.
Current state nursing license RN, LPN, or LVN preferred. Valid driver's license.
Centene offers a comprehensive benefits package, including competitive pay, health insurance, 401K, 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.
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