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At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary***This is a hybrid opportunity that will work from the office 3 days a week. Must live in a commutable distance to the listed office.****Sponsorship will not be provided for this role.*
Summary:
Responsible for operations compliance with accreditation and regulatory requirements regarding NCQA. Responsible for developing, coordinating, integrating, and monitoring accreditation activities and initiatives in compliance to state and federal regulations. Responsibilities include collaborating with partners to collect data and develop compliance documents/evidence for successful accreditation surveys. Monitoring and maintenance of compliance evidence. Educating staff across the organization regarding accreditation standards and requirements. Evaluating current practices. Identifying compliance gaps and recommending solutions to close gaps. Preparing training materials, reports, and materials to support compliance. Coordinating accreditation surveys. Act as subject matter expert, handle complex assignments, and may assist training/mentoring department staff.
Required Job Qualifications:
- Bachelor degree and 2 years of experience in managed care environment OR 6 years work experience in managed care environment.(Managed care environment experience includes one or more of the following areas: audit, health plan operations, compliance or legal.)
- 2 years Accreditation experience (i.e. NCQA, URAC, Joint Commission, CMS) to include managing survey/review experience.
- Knowledge of health care regulatory and legislative process; experience reading and interpreting legislation.
- Experience using Total Quality Management (TQM)/Continuous Quality Improvement (CQI) concepts.
- Knowledge or experience reviewing accreditation standards and evaluating level of compliance, identifying challenges and proposing solutions.
- Knowledge or experience monitoring compliance and managing evidence documents.
- Verbal and written communications skills including training skills.
- Research skills.
- Analytical skills.
- Experience managing multiple complex priorities, often with limited time frames.
- Detail oriented and organizational skills; experience meeting deadlines on time.
- Ability and willingness to travel, including overnight stays
Preferred Job Experience:
- NCQA Accreditation experience HIGHLY PREFERRED
- Project Management (PMP) certification
- Ability to think critically and suggest innovative solutions
We encourage people of all backgrounds and experiences to apply.
Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.
*Sponsorship will not be provided for this role.*
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.