NCQA Quality Accreditation Lead - Denver Health Medical Plan ( Weekly Hybrid Schedule Requirement )

Denver Health•Denver, CO

2d•Hybrid

About The Position

This role is responsible for coordination and maintenance of Denver Health Medical Plan's compliance to meet NCQA (National Committee for Quality Assurance) standards and other regulatory requirements. This role involves overseeing collection and submission of deliverables related to organization quality improvement initiatives, ensuring adherence to regulatory guidelines, and coordinating internal audits. This role is a key team member to support continuous process improvement efforts across all plan departments to successfully achieve and maintain NCQA accreditation status.

Requirements

Bachelor's degree healthcare administration, public health, nursing, or related field required
4-6 years healthcare quality, compliance, or accreditation required
1-3 years supporting NCQA accreditation activities required
1-3 years supporting Medicaid regulatory requirements required
Working knowledge of health plan operations and regulatory standards
Exposure to CMS and Colorado HCPF regulations
Familiarity with HEDIS, Medicare Stars, CAHPS, or similar quality programs
Experience supporting projects or process improvement initiatives
Strong organizational and coordination skills
Solid analytical and problem-solving abilities
Clear and effective communication skills
Attention to detail and accuracy in documentation
Ability to manage multiple tasks and meet deadlines

Responsibilities

Support NCQA accreditation activities, including survey preparation, documentation collection, submission, and follow-up (25%)
Partner with the Compliance team to help monitor adherence to state Medicaid regulatory and contractual requirements (15%)
Assist in reviewing and summarizing accreditation standards and communicating updates to impacted departments (5%)
Coordinate with departmental contacts to support timely completion of accreditation deliverables and ensure engagement (15%)
Serve as a point of contact for internal stakeholders and assist in coordinating communications with NCQA surveyors (5%)
Track project time lines and milestones; support development and maintenance of accreditation work plans (15%)
Facilitate coordination across cross-functional teams (Quality, Compliance, Operations, IT) (5%)
Assist in conducting mock surveys and internal audits to support readiness efforts (5%)
Identify potential compliance gaps and support implementation of corrective action plans (5%)
Support quality initiatives, including HEDIS and CMS Core Measure performance improvement activities (5%)

Benefits

Generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs.
Tuition assistance, career advancement pathways, and professional development
Meaningful financial advantages through loan forgiveness eligibility and employer contributions.
Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
100% paid parental leave up to 6 weeks
Immediate eligibility for retirement plans with employer contribution up to 9.5%
Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
Free RTD EcoPass (public transportation)
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer