Accreditation Manager

POSITION SUMMARY/RESPONSIBILITIES

In collaboration with health plan leadership, responsible for the implementation, evaluation and management of the organization's health plan accreditation activities. Functions as a resource person for accreditation standards as they apply to all aspects of the organization, to include guidance on interpretation and monitoring of standards. Leads and/or coordinates accreditation activities related to patient safety and accreditation standards across the health plan.  Assists in the development of process metrics, data collection tools/systems and presentation/analysis of resultant data. Requires a personal commitment to treat all health plan customers with courtesy, dignity, respect and professionalism and adherence to the organizational Commitment to Service Excellence behaviors and standards.

EDUCATION/EXPERIENCE

Bachelor’s degree in health care or health-related field required. Master’s degree in a health-related field preferred.  Working knowledge of accreditation standards (i.e., NCQA and HEDIS), health care regulations (Centers for Medicare and Medicaid Services and Texas Health and Human Services Commission) and/or process improvement principles required. Strong project management skills and data management skills are required. American Society for Quality certification or similar quality certification is required (Lean Six Sigma Black Belt).

LICENSURE/CERTIFICATION

Current RN licensure in the State of Texas is required, if applicable.