Accreditation Specialist

Centene
Georgia
Workplace: RemoteFull timeUSD 56,200 - 101,000 annuallyFunction: Banking, Lending & CreditExperience: 3+ yearsEducation: bachelorsSkills: []

Develop and coordinate performance improvement initiatives to strengthen clinical quality and outcomes, including NCQA and HEDIS project work with delegated vendors. Maintain accreditation readiness schedules, create policies and procedures for accreditation activities, and deliver training for plans, provider networks, and delegated vendors. Coordinate NCQA/HEDIS work plan activities and support delegation oversight audits with corrective action planning to ensure compliance.

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Centene
Centene
3 days ago

Accreditation Specialist

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Last checked: 4 hours agoStatus: Live

Job Summary

Develop and coordinate performance improvement initiatives to strengthen clinical quality and outcomes, including NCQA and HEDIS project work with delegated vendors. Maintain accreditation readiness schedules, create policies and procedures for accreditation activities, and deliver training for plans, provider networks, and delegated vendors. Coordinate NCQA/HEDIS work plan activities and support delegation oversight audits with corrective action planning to ensure compliance.
Location: Georgia
Workplace: Remote
Employment Type: Full time
Job Function: Banking, Lending & Credit
Seniority: Mid level

Key Responsibilities

  • •Develop Performance Improvement projects to improve clinical quality and performance measure outcomes.
  • •Coordinate delegation oversight mechanisms and act as liaison for the Plan with Corporate Delegation Oversight.
  • •Develop and maintain accreditation readiness schedules.
  • •Create policy and procedures to support accreditation activities.
  • •Support NCQA and HEDIS work plan activities, including delegation oversight audits and corrective action plans.

Pay and Benefits

Salary: USD 56,200 - 101,000 annually
Perks:Health Insurance401kEquityPaid Leave

Key Requirements

  • •Bachelor’s degree in Business or related field, or equivalent experience.
  • •3+ years of related quality improvement, HEDIS and/or NCQA experience.
  • •Develop Performance Improvement projects to improve clinical quality and performance measure outcomes.
  • •Develop and maintain accreditation readiness schedules.
  • •Conduct training and education programs to support NCQA and HEDIS activities.
Experience:3+ years
Education:Bachelor's
Tech Stack:NCQAHEDISAccreditation readinessPerformance improvementDelegation oversightCorrective action plans

Eligibility

Visa:H-1BL-1O-1H-1B1F-1J-1OPTCPT
Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn