DescriptionSHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.
Location: Can be Remote: IN, MD, FL, TX, CA
We are seeking a highly motivated Accreditation Manager with experience in survey preparation of NCQA accreditation in managed care setting. The Accreditation Manager will be responsible for accreditation activities necessary for attaining / maintaining NCQA health plan accreditation.
Primary duties may include, but are not limited to:
- Manages the overall NCQA survey processes and identification of resources required to successfully lead the plan through NCQA accreditation.
- Evaluates, interprets and understands NCQA accreditation guideline requirements and manages the process for accreditation activities.
- Conducts the ongoing evaluation and interpretation of quality improvement and accreditation standards to ensure compliance through documentation, including reporting and measurement studies/ methodologies.
- Facilitates project management and develops comprehensive accreditation work plans by establishing deliverables, accountabilities, and timelines.
- Performs quantitative and qualitative analysis of quality related data and reports activities and works collaboratively with internal clients to ensure barrier analysis and improvement opportunities are identified.
- Interfaces collaboratively with internal clients in the identification and implementation of appropriate interventions to meet NCQA compliance.
- Serves as expert resource to quality committees and business owners across the organization.
- Leads and provides oversight of Core NCQA team accreditation projects.
What You Contribute:
Requires BA/BS in a health care field, and 3-5 yrs healthcare-related experience in addition to 3+ years experience in a QA/QI related position, project management, and strong quantitative, qualitative and analytical skills or any combination of education and experience, which would provide an equivalent background.
- Successful NCQA/URAC accreditation process completion and continuous process improvement experience in an NCQA/URAC setting highly preferred.
- NCQA accreditation survey preparation in managed care setting experience required.
- Experience in Medicaid line of business preferred.
- Must be able to work independently.
- Experience in NCQA Long-Term Services and Supports (LTSS) Distinction for Health Plans
- Clinical background, e.g. RN or LVN strongly preferred.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.