Job description
You could be the one who changes everything for our 26 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.Position Purpose: Ensure compliance with accreditation requirements and conduct routine readiness assessment and evaluation of policies and procedures, processed and records
Oversee the health plan NCQA preparations for accreditation surveys
Educate the health plans on NCQA and/or Center for Medicare/Medicaid Services (CMS) standards and requirements
Evaluate compliance of the corporations Medicare plans with NCQA Health Plan and SNP standards and reporting requirements
Lead policy and procedure documentation reviews for the health plans based on NCQA standards
Develop readiness assessment schedules, conduct accreditation audits and ensure changes to the standards are incorporated
Oversee the development of organization •wide initiatives to support accreditation
Maintain work processes to meet the latest NCQA/URAC accreditation standards
Assist with training and education development to promote accreditation standards
Education/Experience: Bachelor’s degree in Nursing, Healthcare Administration, related field or equivalent experience. 4+ years of quality improvement, regulatory compliance and/or auditing experience. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
License/Certification: Current state nursing license RN, LPN or LVN preferred. Valid driver’s license.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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