Accreditation Program Specialist
Core
Leads cross-functional projects and serves as a subject matter expert for Federal Employee Program (FEP) and local Blue Plans Health Plan Accreditation, ensuring compliance with NCQA and URAC standards.
Role type
Senior IC Accreditation Program Specialist
Builds
Health Plan accreditation compliance strategies, documentation, and survey readiness for FEP and Blue Plans
Domain
Health Insurance / Managed Care / Quality Assurance
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Health Plan accreditation standards expertise, NCQA Corporate Survey knowledge, URAC accreditation knowledge, project management, strategic planning, stakeholder relationship management, conflict resolution, data analysis, presentation skills
Preferred skills
Registered Nurse (RN) licensure, experience managing cross-departmental projects
Technologies
Microsoft Project, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, NCQA Interactive Survey Tool, AccreditNet
Responsibilities
Develop accreditor-compliant documentation for NCQA and URAC submissions, conduct reviews to ensure compliance with accreditation standards, present accreditation topics to Plans via Town Hall calls, translate trend information into strategic action plans, lead or participate in teams to implement recommendations and conduct mock surveys, manage variances within internal departments and Plans to ensure successful accreditation surveys
Seniority
Senior, hands-on IC