Accreditation Specialist
Core
Develop Performance Improvement projects to improve clinical quality and performance measure outcomes for healthcare plans.
Role type
Accreditation Specialist (Quality Improvement)
Builds
NCQA and HEDIS accreditation readiness, quality improvement projects, and compliance reporting.
Domain
Healthcare administration / Quality assurance
Required skills
NCQA accreditation, HEDIS reporting, Quality Improvement (QI) project development, delegation oversight, policy and procedure creation, audit coordination, corrective action planning
Preferred skills
Experience with delegated vendors, training program development
Technologies
NCQA standards, HEDIS metrics
Responsibilities
Develop and coordinate delegation oversight mechanisms; maintain accreditation readiness schedule; create policies and procedures for accreditation; conduct training and education programs for plans, providers, and vendors; develop QI, NCQA, and HEDIS projects; coordinate NCQA and HEDIS work plan activities; assist with delegation oversight audits and corrective action plans.
Seniority
Mid-level, hands-on IC
