Director-Accreditation (Full Time, Remote, North Carolina Based)

The Director of Accreditation is responsible for the design, development, implementation, on-going improvement and maintenance of quality initiatives necessary for attaining NCQA accreditation including overseeing documentation, evidence, surveys and policies to ensure compliance. This role will guide Alliance Health in obtaining and maintaining accreditation readiness and will spearhead the development and implementation of specific initiatives that address any gaps in requirements.

The successful candidate will have expertise in quality improvement principles, accreditation standards, and project management, and must have previous experience with leading an organization through the NCQA accreditation process.

 This position is full time remote. Candidates who are residents of North Carolina are strongly preferred. While there is no expectation of being in the office routinely, they may be required to report to the Alliance office for business meetings as needed.

Responsibilities & Duties

Accreditation Oversight

• Leads the development, organization and implementation and oversees the NCQA accreditation requirements including but not limited to planning program documents, evidence, surveys, programs/projects, policies and procedures and systems relevant to the corporate accreditation needs
• Directs NCQA Accreditation work plans and advises Alliance on them to ensure that the accreditation requirements are met and maintained 
• Responsible for ongoing administrative, clinical, fiscal and programmatic interactions and communication with NCQA key contacts
• Reviews yearly NCQA standards and guidelines for changes and communicates any necessary adjustments to a wide variety of internal and external stakeholders
• Creates policies and procedures to support accreditation activities
• Direct oversight of external consultant utilized for accreditation purposes

Performance Monitoring, Evaluation and Reporting

• Responsible for evaluation of accreditation requirements against corporate performance, developing the workplan calendar and facilitating closure of identified gaps
• Assures that Alliance reaches and maintains a constant state of accreditation readiness
• Gathers necessary data to ensure compliance with all accreditation guidelines
• Oversees the department staff to plan and organize collaborative Quality Improvement activities related to NCQA Accreditation
• Leads all required NCQA reporting by working with all staff to collect data and prepare any necessary reports
• Ensures compliance with delegated functions across accredited products
• Facilitates corrective action plans to ensure compliance with all state, federal, contract and accreditation requirements

Accreditation Subject Matter Expert

• Functions as the resource individual for accreditation standards as they apply to all aspects of the organization, including guidance on interpretation and monitoring of standards
• Provides consultation, interpretation and implementation of accreditation or certification activities to the rest of the organization
• Assists with training and education development to promote and support accreditation standards

Project Management

• Maintains updated application for health plan accreditation and completes submissions in a timely manner
• Coordinates assigned NCQA and HEDIS work plan activities

Staff Management and Development

• Conducts all activities related to direct supervision of accreditation staff and consultants
• Promotes a positive, diverse and inclusive work culture, focusing on staff mentoring and development
• Sets goals for performance and deadlines aligned with the organization’s overall goals and vision

Minimum Requirements

Education & Experience

Bachelor’s degree in healthcare related field, public health administration or other related field and at least seven (7) years working in an integrated health care environment.

Must have at least five (5) years of experience in a progressively more responsible leadership role in quality management operations including at least three (3) years of experience in a management role leading in all phases of effective supervision of multiple direct reports. 

Experience must include at least five (5) years of NCQA accreditation oversight experience including HEDIS oversight.

Preferred:

• Master’s degree in business administration; healthcare administration or other healthcare related fields
• Certified Professional in Healthcare Quality (CPHQ)
• Project Management Professional (PMP) Certification
• Knowledge, Skills, & Abilities
• Superior knowledge of NCQA and HEDIS accreditation standards and healthcare regulations
• Extensive experience working with health plan quality initiatives and accreditation
• Proven track record of successfully leading an organization through the NCQA accreditation application and process
• Demonstrated leadership experience and critical thinking/problem solving skills
• Experience managing project involving cross-departmental teams
• Proven record of thinking conceptually and mastering complex subject matter quickly
• Ability to lead and influence people with various levels of skills and competencies
• Innovative approach to problem solving
• Medicaid Managed Care

Salary Range

$116,926 - $154,926/ Annual

 Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity

 An excellent fringe benefit package accompanies the salary, which includes:   

• Medical, Dental, Vision, Life, Long Term Disability
• Generous retirement savings plan
• Flexible work schedules including hybrid/remote options
• Paid time off including vacation, sick leave, holiday, management leave
• Dress flexibility