Manager, Credentialing and Accreditation - CareNu

Chapters Health System • Temple Terrace, FL

1d • $65,996 - $98,994

About The Position

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing! When you become part of the CareNu Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing groundbreaking solutions for our clients' unique needs offering a wide variety of compassionate healthcare choices. Our employees make all the difference in our success! Role: The Credentialing Accreditation Manager is responsible for leading and managing the client health plan through the successful accreditation process. The Manager is a key member of the Quality and Accreditation team within Chapter Health System’s Population Health Division in CareNU.

Requirements

• Bachelor degree in a related medical or business field, or an equivalent combination of work experience and education
• Minimum of four (4) years’ managed care experience involving quality or accreditation
• Minimum of three (3) years’ clinical or health care management experience
• Knowledge of National Committee for Quality Assurance (NCQA) Accreditation requirements
• Excellent verbal and written communication skills; able to prepare recommendations and written documentation in appropriate format and facilitate meetings
• Organizational skills with the ability to handle multiple projects
• Demonstrated ability to interpret accreditation standards, and align business processes accurately and timely
• Satisfactorily complete competency requirements for this position.
• Represent the Company professionally at all times through care delivered and/or services provided to all clients.
• Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.
• Comply with Company policies, procedures and standard practices.
• Observe the Company's health, safety and security practices.
• Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.
• Use resources in a fiscally responsible manner.
• Promote the Company through participation in community and professional organizations.
• Participate proactively in improving performance at the organizational, departmental and individual levels.
• Improve own professional knowledge and skill level.
• Advance electronic media skills.
• Support Company research and educational activities.
• Share expertise with co-workers both formally and informally.
• Participate in Quality Assessment and Performance Improvement activities as appropriate for the position.

Nice To Haves

• Experience with NCQA population health and case management accreditation surveys preferred

Responsibilities

• Responsible to monitor and fully support accreditation for the plan through each renewal cycle, including document review and annotations.
• Responsible for ensuring business owners successfully deliver all accreditation-related standard compliance within defined timeframes, as directed by the client Plan.
• Establishes mechanisms to assess and document each business unit’s level of compliance with each applicable standard; coordinates and oversees the establishment of corrective action for non-compliance.
• Collects and organizes documentation throughout the Organization for ongoing program needs or develops documents to meet needs.
• Facilitates readiness review activities to ensure all accreditation requirements are met.
• Contributes or leads the development of Quality program documents such as the program description, work plan and annual evaluation.
• Conducts training and coaching to facilitate understanding of the accreditation requirements within the Organization and with clients.
• Actively participates in key client quality meetings and shares knowledge of quality activities.
• Performs other duties as assigned.

What This Job Offers

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