Senior Quality Specialist (Accreditation)

Evolent

18h • $78,000

About The Position

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You’ll Be Doing: Put your passion where it meets purpose! Evolent attracts some of the brightest minds in health care. Surround yourself with talented, driven colleagues who share a passion for better health outcomes and a more connected care journey. We are hiring for a Senior Quality Specialist (Accreditation) to join our Quality Team. Join the Evolent Quality Department where we embrace new ideas, drive for compliance for accreditation success and challenge ourselves to deliver to meet all business needs in a collaborative, positive culture. We respect and celebrate individual talents, and team wins while working to achieve a constant state of accreditation survey readiness. This position supports the accreditation and quality functions for Evolent Health. Collaboration Opportunities: The Senior Quality Specialist for Accreditation role will work closely with the NCQA Manager in collaboration with multiple departments in meeting the accreditation document requirements. This role will work autonomously in ensuring compliance with accreditation requirements with ongoing education to leadership, staff and physician group.

Requirements

• 4+ years required in Quality or healthcare related field
• Minimum of 2+ years prior experience with NCQA surveys
• High School Diploma or college degree or higher-level education (tech/certification)
• Able to work independently
• Expertise in data management, data analysis, reports, and project management skills
• Strong working knowledge of Microsoft products and systems
• Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports
• High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.

Nice To Haves

• Lean Six Sigma Certified or similar Quality certification

Responsibilities

• Serves as a member of the quality team.
• Supports the maintenance of a strong quality program and adherence to State, Federal, CMS, Accreditation (NCQA and/or URAC), and contractual requirements.
• Adherence to the organization's ability to be in a constant state of audit readiness.
• Assists in the preparation of customer and external audits
• Assists/leads with annotations and bookmarks for customer audits (i.e. policies and procedures, meeting minutes, other required materials/documents)
• Assists/leads with gathering documents for accreditation audits
• Assist leadership with finalizing documents for submission for accreditation
• Facilitate meetings with internal stakeholders as needed
• Assist with projects for gap analysis, compliance risk with accreditation standards
• Assist with reviewing released accreditation standards, education as applicable
• Assist with project management of documents, timelines for preparation of audits
• Work collaboratively with quality team and leadership for delegation vendor oversight
• Assist with review of vendor/delegate contracts and participates in pre-delegation
• Assist with vendor/delegate annual oversight for accreditation requirements (P&Ps/document review)
• Assists with policies and procedure review for accreditation requirements
• Responsible in assisting with providing the data for the Monthly Operations Report (MOR) as applicable
• Knowledgeable and/or SME in accreditation requirements
• Any other duties as assigned by Manager or Quality leadership

Benefits

• As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees