NCQA Accreditation Specialist

WHO YOU ARE

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Does this sound like you? If so, we should talk.

WHO WE ARE

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants.

We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients.

We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.

YOUR ROLE

The NCQA Accreditation Specialist is responsible for operations compliance with accreditation and regulatory requirements regarding NCQA.  You will be responsible for developing, coordinating, integrating, and monitoring accreditation activities and initiatives in compliance with state and federal regulations.

PRIMARY FUNCTIONS

• Collaborate with internal partners to collect data and develop compliance documents/evidence for successful accreditation surveys
• Monitor and maintain comprehensive compliance documents and evidence to ensure successful accreditation survey and ensure adherence to NCQA standards
• Maintain up-to-date records.
• Educate staff across the organization regarding accreditation standards and requirements
• Evaluate current practices and identify compliance gaps and recommend solutions to close gaps
• Prepare training materials, reports, and materials to support compliance
• Coordinate accreditation surveys and serve as a point of contact during surveys to ensure all requirements are met
• Act as subject matter expert, handling complex assignments, and may assist training/mentoring department staff
• Regular and reliable attendance
• Other duties as assigned

HOW YOU QUALIFY

• You reviewed the Who You Are section of this job posting and immediately felt the need to read on. That makes you a match for our innovative culture
• You accept that things change quickly in a startup environment and are willing to pivot rapidly on priorities
• Bachelor's Degree and 2 years of experience in managed care environment OR 6 years of work experience in managed care environment. (Managed care environment experience includes one or more of the following areas: audit, health plan operations, compliance or legal.)
• 2 years Accreditation experience (i.e. NCQA, URAC, Joint Commission, CMS) to include managing survey/review experience
• In-depth knowledge of NCQA standards and accreditation processes
• Knowledge of health care regulatory and legislative process; experience reading and interpreting legislation
• Experience using Total Quality Management (TQM) / Continuous Quality Improvement (CQI) concepts
• Knowledge or experience reviewing accreditation standards and evaluating level of compliance, identifying challenges and proposing solutions
• Knowledge or experience monitoring compliance and managing evidence documents
• Verbal and written communications skills including training skills
• Research skills
• Analytical skills
• Experience managing multiple complex priorities, often with limited time frames
• Detail oriented with strong organizational skills, experience meeting deadlines
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wired to the house internet (Cable, Fiber, or DSL) and hardwired to the internet device is recommended
  • Evergreen will provide Remote or Hybrid Home/Office employees with telephony applications and equipment to meet the business requirements for their position/job
  • Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Job Experience:

• Project Management (PMP) certification
• Ability to think critically and suggest innovative solutions

Pay range for this role is $70,000 to $85,000, with exact pay determined based on experience, education, demand for role, and other role-specific criteria.

HOW YOU’RE SUPPORTED

• You will benefit from Evergreen Nephrology’s exceptional total rewards package, including competitive base pay with bonuses, paid time off starting at four weeks for full-time employees, 12 paid holidays per year, reimbursement for continuing medical education, 401k with match, health, dental, and vision insurance.
• We are proud to offer family-friendly policies that support paid parental leave and flexible work arrangements.
• We commit to a robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology.
• As an inclusive and diverse team, you will collaborate with like-minded healthcare professionals who, like you, understand the importance and value of Evergreen Nephrology’s high-quality, value-based care model.

Evergreen Nephrology is an equal opportunity employer that is committed to inclusion and diversity. We take affirmative action to ensure equal opportunity for all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about your EEO rights as an applicant (Opens in a new window) .

Evergreen Nephrology will not discriminate or retaliate against applicants who inquire about, disclose, or discuss their compensation or that of other applicants. United States Department of Labor. Learn more (Opens in a new window).

Evergreen Nephrology is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email us for assistance. Reasonable accommodations will be determined on a case-by-case basis. 

Common characteristics of the people who comprise Evergreen Nephrology:

Smart, detail-oriented, mission-driven, entrepreneurial, and operates with urgency