The Accreditation Specialist assists the Manager of Accreditation with the implementation and coordination of systems and processes necessary to meet all National Committee for Quality Assurance (NCQA) accreditation standards/elements and factor accuracy. The Specialist also provides subject matter expertise to staff on NCQA Healthplan accreditation items.

This position is remote, with the option to work in the office if preferred. The hire will be required to report on-site in Morrisville, NC, on occasion. The selected candidate must reside in North Carolina.

Responsibilities & Duties

Assist with Accreditation workplan and monitoring

• Assist the Manager of Accreditation with the organization workplan to achieve and maintain Health Plan Accreditation with LTSS distinction and any additional accreditations Alliance Health pursues
• Monitor NCQA FAQ and Policy Updates for relevant changes and communicating those changes appropriately
• Update annual NCQA tracker upon release of new/updated standards
• Review policies and procedures, reports, materials, and files for completeness, accuracy, and compliance with NCQA Standards
• Identify gaps and risks and provide regular status reports from NCQA tracker to appropriate management
• Maintain calendar of documentation due dates, ongoing collection and tagging relevant policies/procedures, reports, materials, and files as appropriate
• Participate in Delegation Oversight and audits as appropriate

Provide Organizational support on Accreditation

• Provide technical support and education to staff regarding NCQA Health Plan Accreditation and LTSS Distinction Standards and supporting documentation
• Work within organizational wide, cross-functional and multi-disciplinary teams to bring each business area to a state of readiness
• Communicate reporting due dates and reminders to business leads and leadership as appropriate
• Maintain clear status updates regarding NCQA Readiness on NCQA Tracker, communicating risks as appropriate

Minimum Requirements

Education & Experience

Associate’s degree in Healthcare, Human Services, Public Health Administration, Business, or related field and three (3) years of administrative/project management experience in a managed care or healthcare setting with work on NCQA Healthplan accreditation.

Or

Graduation from an accredited school of nursing and three (3) year of administrative/project management experience in a mangaged care or healthcare setting swith work on NCQA Healthplan accreditation.

Or

Bachelor’s degree in Healthcare, Human Services, Public Health Administration, Business, or related field and one (1) year of administrative/project management experience in a mangaged care or healthcare setting with work on NCQA Healthplan accreditation.

Preferred experience-

Clinical experience as an RN and preferably a Care Management background

Knowledge, Skills, & Abilities

• Knowledge of NCQA accreditation processes and standards
• Knowledge and Understanding of federal and state regulations
• Planning and organizational skills
• Excellent communication skills (written and verbal).
• Interpersonal skills which are effective, respectful, and sensitive to a diverse and multicultural population of children, families, and co-workers,
• Problem-solving, mediation, and conflict resolution skills
• Teamwork and collaboration skills
• Microsoft Project, Excel, Word (Edits and Tracking), and PowerPoint skills
• Excellent organizational and prioritization skills
• Facilitation skills
• Ability to work in a fast paced environment with frequent interruptions
• Ability to work under minimal supervision

Salary Range

$25.68 to $44.22/Hourly

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.

An excellent fringe benefit package accompanies the salary, which includes:

• Medical, Dental, Vision, Life, Long and Short Term Disability
• Generous retirement savings plan
• Flexible work schedules including hybrid/remote options
• Paid time off including vacation, sick leave, holiday, management leave
• Dress flexibility

Education

• Associates or better in Human Services
• Nursing or better in Nursing
• Bachelors or better in Human Services

Skills

• Communication
• Conflict Management
• Interpersonal Skills
• Microsoft Office
• Planning