Accreditation and Quality Coordinator

Federal Hearings And Appeals•Wilkes-Barre, PA

About The Position

The Accreditation and Quality Coordinator supports the Director with organizational accreditation, document control, and arbitration quality assurance. The role coordinates accreditation activities across the full lifecycle, maintains audit readiness, manages controlled documents, and reviews arbitration outcomes for accuracy, clarity, and compliance. It works with internal departments, the Director, arbiters, QA and Training, committees, and external accrediting organizations as needed.

Requirements

At least 5 years of experience in healthcare accreditation, quality management, audit coordination, document control, or a closely related function.
Hands-on experience supporting at least one accreditation, certification, or external audit cycle, including coordinating evidence collection, preparing submissions, tracking findings, and following corrective actions through completion.
Experience administering controlled documents, including version control, approval workflows, periodic reviews, document inventories, and records retention.
Proficiency with Microsoft Word, Microsoft Excel, and electronic document management or project tracking systems.
Strong organizational, written communication, and follow-through skills, with the ability to manage competing deadlines, maintain accurate records, and handle confidential information.

Nice To Haves

Experience with URAC, NCQA, or ISO; experience with all three is not required.
SharePoint experience.

Responsibilities

Assist the Director in coordinating, implementing, and maintaining organizational accreditations, including NCQA, URAC, and ISO, from initial applications through renewals and reaccreditation.
Coordinate with departments to support compliance with accreditation standards and maintain continuous audit readiness.
Collect, validate, and maintain centralized evidence, documentation, and reports for applications, audits, and renewals.
Develop and maintain accreditation timelines, work plans, and tracking tools; support preparation and submission of applications, annual reports, and responses to accrediting bodies.
Monitor accreditation standard and regulatory requirement changes, and communicate updates to the Director and relevant departments.
Support internal audits, mock audits, and readiness reviews; identify documentation gaps, noncompliance, and improvement opportunities.
Track departmental deliverables and assist with developing and monitoring corrective action plans for audit findings or compliance deficiencies.
Serve as liaison among the Director, internal departments, and external accrediting organizations as needed.
Identify opportunities to streamline workflows, strengthen documentation practices, and improve organizational readiness.
Prepare, update, and maintain controlled documents in FHAS’ Document Control System in accordance with current URAC, NCQA, and ISO requirements.
Manage the document periodic review process and maintain a master list of controlled documents.
Provide quarterly policy and procedure updates to the Quality Management Committee (QMC).
Control project documentation across multiple simultaneous projects and provide document control support for each.
File controlled documents in accordance with FHAS’ Record Retention Policy.
Support internal and regulatory audits and inspections, and perform departmental compliance monitoring as directed by the Compliance and Ethics Committee.
Conduct quality assurance reviews of arbitration outcomes to ensure determinations are accurate, well supported, clearly written, and consistent with FHAS standards, policies, and decision-making guidelines.
Review outcome letters and related communications for compliance with applicable CMS regulations, including required content, language, and timeliness.
Evaluate the application of applicable standards, supporting rationale, and use of the case record in arbiter determinations.
Identify errors, inconsistencies, and compliance gaps; communicate findings to the arbiter, QA & Training, and relevant departments.
Provide feedback, recommend targeted training or coaching, and support corrective action plans to improve arbiter quality and compliance.
Maintain audit-ready documentation of QA reviews, scoring, and findings, and support audits as required.
Contribute to developing and maintaining QA tools, review criteria, scorecards, and sampling methodologies.