Senior Accreditation Specialist

Centene Corporation

1d • Hybrid

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. The Senior Accreditation Specialist serves as a Subject Matter Expert (SME) regarding accreditation standards and continuous quality improvement principles. This role coordinates and performs accreditation oversight and survey readiness, and serves as a lead communicator with health plan and department senior leadership.

Requirements

• Bachelor’s degree in Business, related field or equivalent experience
• 4+ years of related accreditation, quality improvement, HEDIS and/or NCQA experience

Nice To Haves

• CPHQ certification preferred
• Licensed healthcare professional preferred

Responsibilities

• Serves as a SME regarding accreditation standards and continuous quality improvement principles
• Coordinates and performs accreditation oversight and survey readiness
• Serves as a lead communicator with health plan and department senior leadership
• Develop and coordinate delegation oversight mechanisms for complex plans (multiple products, large populations, known gaps, critical time frame for achieving accreditation, etc.)
• Conduct file review, identify gaps, communicate results and perform re-audits as required
• Reviews and updates tools, process documentation and policies related to accreditation
• Develop and maintain accreditation readiness schedule
• Create policy and procedures to support accreditation activities
• Provide training on complex issues affecting identified NCQA file elements, inclusive of creating appropriate training materials as needed and supporting improvement activity carried out either at the health plans or on a corporate basis
• Develop QI, NCQA and HEDIS projects with delegated vendors to support accreditation maintenance and HEDIS reporting
• Coordinate assigned NCQA and HEDIS work plan activities

Benefits

• competitive pay
• health insurance
• 401K
• stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Number of Employees: 5,001-10,000 employees