Accreditation Manager

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

The Accreditation Manager will lead the Plan's efforts to attain and maintain NCQA National Committee on Quality Assurance accreditation. This involves collaboration with both internal and external partners to identify, launch and implement projects and initiatives that support achievement and maintenance of accreditation.

Our Investment in You:

* Full-time remote work

* Competitive salaries

* Excellent benefits

Key Functions/Responsibilities:

* Responsible for organizational readiness for specific NCQA standard areas

* Provides consultation to organizational areas about NCQA standard compliance, reporting and report writing.

* Assists with management of the Quality Improvement Committee.

* Creates documentation related to NCQA evidence.

* Implements quality improvement projects and processes related to NCQA requirements.

* Participates in quality improvement workgroups and provides NCQA subject matter expertise.

* Acts as accreditation expert on specific standards for internal staff at all levels.

Supervision Received:

* General supervision is received weekly.

Qualifications:

Education Required:

* Bachelor's degree or an equivalent combination of education, training, and experience in related field.

Preferred/Desirable:

* Master's degree in a related field.

Experience:

* At least 6 years of healthcare/managed care experience with 3+ years in a quality/accreditation position.

* Demonstrated experience in NCQA accreditation processes, evidence preparation and evaluation.

* Understanding of quality improvement principles and methods and experience in quality improvement project management.

Competencies, Skills, and Attributes:

* Understanding of quality principles (i.e. CQI, TQM).

* Ability to conduct data mining.

* Ability to facilitate process improvement efforts.

* Ability to develop and utilize metrics and other oversight mechanisms.

* Highly developed organizational and analytical skills with sharp attention to detail.

* High proficiency in Microsoft Office including Word, Excel, PowerPoint and Visio.

* Strong ability to foster relationships and build consensus; strong interpersonal skills.

* Ability to lead cross-functional groups, interact will all levels and areas of the organization, and interact with both clinical and non-clinical teams or individuals.

Working Conditions and Physical Effort:

* Regular and reliable attendance is an essential function of the position.

* Work is normally performed in a typical interior/office work environment.

* No or very limited physical effort required. No or very limited exposure to physical risk.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees