Accreditation & Survey Readiness Coordinator - SHCN
Position Purpose: Under the direction of the Sr. Manager, the Accreditation & Survey Readiness Coordinator (ASRC) supports all facets of the accreditation process and survey readiness across multiple lines of business, as applicable, including Medicaid and Medicare Advantage Health Plans as well as the
Steward Accountable Care Organizations.
Assist the Sr. Manager with the collection, review, preparation and submission of health plan documentation needed for an accreditation survey including but not limited to:
· Review of organizational policies and procedures and citing the correct accreditation standard/element/factor within the document
· Identify and report any gaps in policy or procedure, as related to accreditation, to the Sr. Manager
· Assist in preparation of the accreditor’s survey work tool in order to ensure timely submission of the survey documentation
Assist the Sr. Manager in performing annual gap analyses across multiple lines of business to ensure health plans are able to operationalize the annual updates to NCQA accreditation standards. The gap analyses will include but are not limited to:
· Assist in an annual review and comparison of the current year’s accreditation standards against the next year’s standards revisions to determine areas of risks to maintaining accreditation and reporting any findings to the Sr. Manager for follow-up
· Assist in the development and maintenance of an ongoing project plan for managing and reporting accreditation activities across all product lines
Assist the Sr. Manager in conducting survey readiness auditing and monitoring activities to support organizational accreditation (i.e. NCQA) and regulatory monitoring requirements (i.e. CMS Model of Care, state-mandated EQRO reviews, state Operational Reviews).
· Assist in the development and maintenance of internal audit tools to be used to conduct survey readiness assessments and monitoring
· Perform survey readiness monitoring using internal audit tools with the goal being that the most stringent standard, either accreditation or regulatory, is being followed by the health plan
· Complete readiness monitoring audits and any other assigned tasks within the timeframe provided by the Sr. Manager. Immediately report any deficiencies or risks identified during readiness monitoring immediately to the Sr. Manager
Support Health Plan activities to ensure proper implementation and dissemination of accreditation and regulatory requirements. Also serve as a resource to other departments for compliance with accreditation standards.
· Assist Sr. Manager with the development of power-point presentations targeting Quality and Accreditation to be used by the Human Resources department for employee education activities (i.e. I-HEAL)
· Represent the Quality Management department and speak to onboarding employees during new hire orientation about health plan quality and accreditation. Additionally, attend staff meetings within the organization and provide a Quality and Accreditation presentation.
· High school diploma or GED equivalent
· Some college preferred
Years of Experience:
· 1 year HMO/Managed Care experience preferred
· Personal computer proficiency with Microsoft Office - Word, Excel, Outlook, and PowerPoint
· Data analysis, problem solving, organizational, detail orientation, and writing skills
· Ability to work in a team environment
· Strong time management skills
· Strong interpersonal and communication skills
· Needs assessment and data analysis skills sufficient to monitor and evaluate quality improvement activity outcomes preferred
· Knowledge of performance standards as applicable to the health plan accreditation process
· Maintains confidentiality and projects a professional business image
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled