Accreditation Specialist

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 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.

📋 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