Serve as the project management lead and subject matter expert for assigned NCQA standard areas
Manage the assessment of related business functions for corresponding departments within the scope of NCQA standards
Support high-quality performance and ensure successful NCQA Accreditation process
Support the Continuous Quality Improvement Committee
Implement and Monitor Accreditation Workplan
Identify gaps and risks and provide regular status reports from NCQA tracker to leadership
Serve as lead for NCQA Accreditation reviews for assigned standard categories
Review and update policies and procedures, reports, materials, and files
Participate in Delegation Oversight and audits
Provide technical support and education to staff regarding NCQA Health Plan Accreditation
Assess business area functions against current and upcoming NCQA standards
Communicate reporting due dates and reminders to business leads and leadership as appropriate
Maintain clear status updates regarding NCQA Readiness on NCQA Tracker

Bachelor’s degree in Healthcare, Human Services, Public Health Administration, Nursing, Business, or related field
Three (3) years of project management experience in a managed care or healthcare setting
Knowledge and practical experience health care quality or NCQA Health Plan accreditation processes and requirements
Experience with NCQA Accreditation standards
Knowledge of regulatory reporting, compliance requirements, and auditing procedures
Project management skills
Knowledge of NCQA accreditation processes and standards
Knowledge and understanding of federal and state regulations
Planning, project management and organizational skills
Excellent communication skills (written and verbal)
Interpersonal skills which are effective, respectful, and sensitive to a diverse and multicultural population of children, families, and co-workers
Problem-solving, mediation, and conflict resolution skills
Teamwork and collaboration skills
Microsoft Project, Excel, Word (Edits and Tracking), and PowerPoint skills
Facilitation skills

NCQA Quality & Accreditation Specialist

Key skills