Accreditation Specialist

Centene Corporation•Remote-GA, GA

1d•$56,200 - $101,000•Remote

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Applicants for this role have the flexibility to work remotely within the continental United States. To support the needs of the business, preferred schedule is based on Eastern Standard Time zone.

Requirements

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT
Bachelor’s degree in Business, related field or equivalent experience.
3+ years of related quality improvement, HEDIS and/or NCQA experience.

Responsibilities

Develop Performance Improvement projects to improve clinical quality and performance measure outcomes.
Develop and coordinate delegation oversight mechanisms and act as liaison for the Plan with Corporate Delegation Oversight.
Develop and maintain accreditation readiness schedule.
Creates policy and procedures to support accreditation activities.
Conduct training and education programs for Plan, provider network, delegated vendors to support NCQA and HEDIS activities.
Develop QI, NCQA and HEDIS projects with delegated vendors to support accreditation maintenance and HEDIS reporting.
Coordinate assigned NCQA and HEDIS work plan activities.
Assist with delegation oversight audits and coordinate corrective action plans to ensure compliance with all state, federal, contract and accreditation requirements.