MedStar Medical Group Job - 50069039 | CareerArc
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Company: MedStar Medical Group
Location: Baltimore, MD
Career Level: Entry Level
Industries: Not specified

Description

General Summary of Position
The NCQA Accreditation Coordinator will be responsible for managing the accreditation process for our Medicaid Health Plan MCO. This role involves ensuring compliance with the National Committee for Quality Assurance (NCQA) standards and requirements. The coordinator will work closely with internal departments to maintain and enhance the quality of care provided to our members, ensuring continuous readiness for NCQA accreditation.


Primary Duties and Responsibilities

  • Leads and coordinate all activities related to NCQA accreditation.
  • Ensures compliance with NCQA standards, guidelines, and timelines.
  • Serves as the primary point of contact for NCQA and external auditors.
  • Develops, reviews, and updates policies and procedures to align with NCQA standards.
  • Ensures all documentation is complete, accurate, and up-to-date.
  • Creates compliance documents and evidence to support successful accreditation surveys
  • Assists in the development and implementation of quality improvement projects and initiatives.
  • Monitors performance metrics and ensure continuous improvement in quality of care.
  • Implements processes to monitor, evaluate, and enhance the quality and safety of care provided to our members.
  • Conducts internal audits to assess compliance with NCQA standards.
  • Identifies gaps in compliance and work with relevant departments to implement corrective actions.
  • Provides training and education to staff on NCQA standards and accreditation requirements.
  • Develops training materials and resources to support staff education.
  • Collects and analyzes data related to quality measures and NCQA requirements.
  • Prepares reports and presentations for internal and external stakeholders.
  • Collaborates with various departments including Clinical Operations, Member Services, and Provider Relations to ensure compliance with NCQA standards.
  • Works with IT and data management teams to ensure accurate data collection and reporting.
  • Maintains comprehensive records and documentation related to accreditation activities.
  • Prepares and submits required reports to NCQA and other regulatory bodies.

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    Minimum Qualifications
    Education

    • Bachelor's degree Bachelor's degree in healthcare administration, nursing or related field required and
    • Master's degree Master's degree in healthcare administration, nursing or related field preferred

    Experience

    • 1-2 years 1 to 2 years prior experience in health plan accreditation or credentialing preferred
    • One year of relevant professional-level work experience may be substituted for one year of required education.

    Knowledge, Skills, and Abilities

    • NCQA Knowledge: Familiarity with NCQA accreditation standards and requirements, particularly within the context of Medicaid MCOs.
    • Attention to Detail: Strong organizational skills and attention to detail for accurate documentation.
    • Collaboration: Ability to work collaboratively with cross-functional teams.
    • Analytical Skills: Proficiency in analyzing data and identifying areas for improvement.
    • Communication: Excellent written and verbal communication skills.


    This position has a hiring range of $63,793 - $107,411

     


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