Accreditation Specialist

Job not on LinkedIn

đź•’ August 17

🇺🇸 United States – Remote

đź’µ $56.2k - $101k / year

⏰ Full Time

🟡 Mid-level

đźź  Senior

đź‘» Ghost score 0%

infoinfo
Apply Now
Find Similar Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Logo of Centene Corporation

Centene Corporation

10,000+ employees

Founded 1984

🛡️ Insurance

đź’Ľ Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

đź“‹ Description

• Develop Performance Improvement projects to improve clinical quality and performance measure outcomes • Develop and coordinate delegation oversight mechanisms and act as liaison for the Plan with Corporate Delegation Oversight • Develop and maintain accreditation readiness schedule • Create policies and procedures to support accreditation activities • Conduct training and education programs for Plan, provider network, and delegated vendors to support NCQA and HEDIS activities • Develop QI, NCQA and HEDIS projects with delegated vendors to support accreditation maintenance and HEDIS reporting • Coordinate assigned NCQA and HEDIS work plan activities • Assist with delegation oversight audits • Coordinate corrective action plans to ensure compliance with all state, federal, contract, and accreditation requirements

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Bachelor's degree in Business, related field, or equivalent experience • 3+ years of related quality improvement, HEDIS and/or NCQA experience

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules

Apply Now

Similar Jobs

đź•’ August 17

MSD

10,000+ employees

🏥 Healthcare

📦 Logistics

🧬 Biotechnology

Cardiovascular sales specialist driving healthcare product adoption across Indiana territories for Merck. Managing provider relationships, territory plans, compliant product discussions, and market performance.

🇺🇸 United States – Remote

đź’µ $79.2k - $124.7k / year

⏰ Full Time

🟡 Mid-level

đźź  Senior

🦅 H1B Visa Sponsor

infoinfo

đź•’ August 17

Pfizer

10,000+ employees

đź’Ľ Consulting

📣 Marketing

đź’Š Pharmaceuticals

Pfizer cardiovascular sales specialist promoting therapies to Buffalo healthcare providers. Managing territory strategy, customer relationships, analytics, and compliant product education remotely.

🇺🇸 United States – Remote

đź’µ $76k - $199.6k / year

đź’° Post-IPO Debt on 2023-05

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

infoinfo

đź•’ August 17

RTX

10,000+ employees

🏭 Manufacturing

đź’Ľ Consulting

📦 Logistics

Supplier Development Lead driving recovery, capability improvement, and transitions for aerospace suppliers at RTX and Collins Aerospace. Managing quality, delivery, APQP, and sustainable performance worldwide.

🇺🇸 United States – Remote

đź’µ $107.5k - $204.5k / year

⏰ Full Time

đźź  Senior

đź•’ August 17

Cotiviti

5001 - 10000

🏥 Healthcare

đź’Ľ Consulting

📦 Logistics

Payment Accuracy COB Specialist 2 auditing healthcare claims and coordinating benefits for Cotiviti. Conducting complex investigations, quality checks, appeals, and overpayment identification remotely in the US.

🇺🇸 United States – Remote

đź’µ $26 - $29 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

infoinfo

đź•’ August 17

KoBold Metals

51 - 200

🤖 Artificial Intelligence

🔬 Science

⚡ Energy

Communities and Social Performance Specialist supporting Indigenous engagement, social due diligence, and compliance. Strengthening community relationships across KoBold Metals’ AI-driven mineral exploration projects.

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

đźź  Senior