MedStar Medical Group Job - 50350024 | CareerArc
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Company: MedStar Medical Group
Location: Baltimore, MD
Career Level: Mid-Senior Level
Industries: Not specified

Description

General Summary of Position
Leads the accreditation process for our Medicaid Health Plans to ensure compliance with the National Committee for Quality Assurance (NCQA) standards. Under the supervision of the Director of Quality, works across all MFC internal teams/leaders and committees to ensure MFC performance reflects equitable care and service delivery inherent in NCQA standards. Uses knowledge of the NCQA standards and processes to achieve and maintain accreditation. This position requires outstanding project management skills and extensive knowledge of NCQA accreditation standards, as well as being an inspiring, collaborative, and innovative leader with an ability to engage and educate all MFC team members. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels.


Primary Duties and Responsibilities

  • Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
  • Leads collaboration with internal and external partners to identify, launch and implement projects and initiatives that support achievement and maintenance of accreditation(s).
  • Leads the preparation of all organizational NCQA accreditation survey submissions. Coordinates accreditation activities for all MFC departments, including preparing documentation, conducting internal audits and participating in external audits. Develops, prepares/edits documentation for NCQA accreditation survey submission.
  • Monitors and analyzes data to identify trends, opportunities and areas for improvement. Produces documents that summarize findings and recommendations. Prepares reports on the findings of audits, reviews and program evaluations.
  • Oversees the development, maintenance and annual review of policies and procedures related to accreditation standards. Ensures existing MFC policies and procedures are following both NCQA standards and state regulations. Leads the Maryland Policy Review workgroup.
  • Maintains knowledge of and compliance with current accreditation standards and regulatory requirements. Advises on the development and distribution of accreditation best practices.
  • Oversees the development and coordination of departmental and staff trainings on accreditation standards and quality improvement initiatives.
  • Supervises the NCQA Accreditation Coordinators in achieving all accreditation and job responsibilities.
  • Serves as liaison between MFC and the NCQA consultant agency.
  • Coordinates and leads cross departmental committee meetings.
  • Collaborates with other departments and applicable leaders to develop department specific workplans, address identified gaps and implement corrective action plans, as appropriate; and supports the workplan goals through the facilitation of various workgroups.
  • Reports to and collaborates with the Director of Quality to ensure organizational readiness for accreditation surveys by maintaining ongoing status workplans, ensuring completion of ongoing activities and escalates potential compliance issues.

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    Minimum Qualifications
    Education

    • Bachelor's degree in a relevant field (i.e., Public Health, Community Health, Health Administration, Nursing) required and
    • Master's degree in a relevant field (i.e., Public Health, Community Health, Health Administration, Nursing) preferred

    Experience

    • 5-7 years Working in Accreditation/Quality in a Medicaid orgainization required and
    • 3-4 years NCQA Accreditation Leadership (Successful achievement of NCQA accreditation) required
    • One year of relevant professional-level work experience may be substituted for one year of required education.

    Licenses and Certifications

    • CPHQ - Certified Professional in Healthcare Quality Certified Professional in Healthcare Quality (CPHQ) preferred or
    • Certified Project Management Professional (PMP)-PMI Project Management Professional (PMP) certification preferred

    Knowledge, Skills, and Abilities

    • Excellent written and verbal communication skills.
    • Ability to follow verbal and written instructions.
    • Attention to detail and ability to meet strict deadlines.
    • Team player and the ability to influence others.
    • Ability to operate effectively across organizational boundaries.
    • Proficient with Microsoft Office applications, especially Word, PowerPoint, and Excel.
    • Proficient with Adobe Acrobat Pro with ability to learn and apply additional software.


    This position has a hiring range of $80,995 - $130,998

     


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