Professional, Accreditation and Quality Regulatory Compliance

MVP Health Care • Schenectady, NY

17d

About The Position

Join Us in Shaping the Future of Health Care At MVP Health Care, we’re on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference—every interaction, every day. We’ve been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team. What’s in it for you: Growth opportunities to uplevel your career A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team Competitive compensation and comprehensive benefits focused on well-being An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace. You’ll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities. This role assists the Sr. Leader, Accreditation and Quality Regulatory Compliance in strategic planning and management of the National Committee for Quality Assurance (NCQA) Health Plan Accreditation process. This role will work directly with leadership teams, key business owners or contributors across the organization, and key external stakeholders to support the design, implementation, and oversight of Quality Accreditation and Compliance strategic initiatives, along with the regulatory and operational responsibilities related to the Quality Committee Structure. This individual will serve as a subject matter expert and liaison for NCQA Standards interpretation, survey preparation, onsite/virtual survey file reviews and associated follow up activities based upon surveyor feedback. Will develop and maintain accreditation work plans, timelines and documentation. Assists business owners/leaders in ongoing NCQA Accreditation Standards training annually, develops and/or evaluates departmental policies and procedures for compliance with NCQA Health Plan Accreditation Standards. In conjunction with the Sr. Leader, Accreditation and Quality Regulatory Compliance, assumes ownership of the Quality trilogy documents, including the Quality Improvement Program Description, Quality Improvement Work Plan and the Quality Improvement Annual Report. Assures these trilogy documents are updated annually, establishes timeframes for documentation revisions and review by key stakeholders, reviews for requirement accuracy and brand standards and is submitted timely to the Quality Improvement Committee and the Board of Directors for final approval. Assists with the monthly Accreditation Workgroup meeting by developing and coordinating agenda topics, educational training slides and presentation of content as required or by the request of business owners. Performs other duties as assigned.

Requirements

• Bachelor’s degree required. BA/BS in Health Care Administration, Business Administration, Registered Nursing, Medical Compliance or related field required.
• Professional level experience related to health care or health insurance programs, processes and/or operations required.
• NCQA Health Plan Accreditation experience with successful submission in the last 3 years.
• Detail-oriented worker with excellent organizational skills, able to work on multiple projects simultaneously and meet deadlines.
• Ability to organize, analyze and present data effectively
• Strong analytical and critical thinking skills
• Ability to work and make decisions independently
• Exceptional time management skills
• Excellent oral and written communication skills
• Highly effective interpersonal and conflict management skills
• Ability to use discretion in handling confidential information
• Strong computer knowledge (Excel, PowerPoint, Microsoft Project, Access, and Word).

Nice To Haves

• Master’s degree in a related field strongly preferred.
• Other meaningful healthcare experience will be considered.

Responsibilities

• Assists the Sr. Leader, Accreditation and Quality Regulatory Compliance in strategic planning and management of the National Committee for Quality Assurance (NCQA) Health Plan Accreditation process.
• Works directly with leadership teams, key business owners or contributors across the organization, and key external stakeholders to support the design, implementation, and oversight of Quality Accreditation and Compliance strategic initiatives, along with the regulatory and operational responsibilities related to the Quality Committee Structure.
• Serves as a subject matter expert and liaison for NCQA Standards interpretation, survey preparation, onsite/virtual survey file reviews and associated follow up activities based upon surveyor feedback.
• Develops and maintains accreditation work plans, timelines and documentation.
• Assists business owners/leaders in ongoing NCQA Accreditation Standards training annually, develops and/or evaluates departmental policies and procedures for compliance with NCQA Health Plan Accreditation Standards.
• In conjunction with the Sr. Leader, Accreditation and Quality Regulatory Compliance, assumes ownership of the Quality trilogy documents, including the Quality Improvement Program Description, Quality Improvement Work Plan and the Quality Improvement Annual Report.
• Assures these trilogy documents are updated annually, establishes timeframes for documentation revisions and review by key stakeholders, reviews for requirement accuracy and brand standards and is submitted timely to the Quality Improvement Committee and the Board of Directors for final approval.
• Assists with the monthly Accreditation Workgroup meeting by developing and coordinating agenda topics, educational training slides and presentation of content as required or by the request of business owners.
• Performs other duties as assigned.

What This Job Offers

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