Accreditation Specialist

Lucet • ,

12d • $68,000 - $78,000 • Remote

About The Position

At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our purpose is to advocate for and improve the overall well-being of those we serve, through balanced treatment of the mind and body. When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives. We are a team of collaborative and hard-working professionals working to improve behavioral health outcomes working in a fast-paced and changing environment. At Lucet, no two days are the same. If you find joy in meaningful work and delivering excellent results, we encourage you to apply! We are looking for top-tier skills and experience in our remote-work environment and that’s because we offer top-tier compensation and benefits. At Lucet, your work will directly support our mission to improve behavioral, physical, and social health—one member at a time.

Requirements

• Bachelor's degree in healthcare administration, nursing, or a related field.
• 3+ years of experience in case management, utilization review or auditing.
• 1+ years of experience in a managed care environment
• Experience with NCQA, URAC, CMS, or Joint Commission accreditation standards
• Microsoft office and Excel spreadsheet manipulation knowledge/experience
• Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.
• Attention to Detail: Ability to meticulously review and audit medical records for accuracy and compliance.
• Analytical Skills: Strong capability to identify discrepancies and non-compliance issues in documentation.
• Communication Skills: Effective in liaising with healthcare providers and internal teams, and in educating staff.
• Regulatory Knowledge: In-depth understanding of Commercial, Medicare, Medicaid, and private insurance guidelines.
• Problem-Solving: Proficient in developing action plans and recommending process improvements.
• Training and Education: Skilled in providing training on documentation best practices, compliance standards, and utilization management.

Responsibilities

• Support accreditation activities by preparing audit materials, maintaining documentation, and tracking performance metrics.
• Monitor compliance with accreditation and managed care requirements (NCQA, URAC, Commercial, Medicare Advantage, Medicaid, Marketplace).
• Collect, organize, and track utilization, network, case management, and quality performance data, including key KPIs.
• Identify trends, investigate root causes, and escalate accreditation‑related performance gaps to leadership.
• Partner with UM, CM, quality, network, and credentialing teams to identify and document process improvement opportunities.
• Support staff education, develop training materials, and assist with accreditation survey readiness and compliance reinforcement.

Benefits

• Annual compensation between $68,000 - $78,000, PLUS an annual performance-based, discretionary incentive.
• Comprehensive health benefit options: Medical, dental, and vision coverage
• 401(k) with competitive employer match
• Company-paid life and disability insurance
• Paid parental leave and wellbeing incentives
• Generous paid time off, including volunteer time
• Flexible spending accounts for healthcare and dependent care
• Professional development opportunities and tuition reimbursement
• Remote work flexibility (role-dependent)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level