Accreditation Specialist

Centene Corporation; Georgia; Hybrid; USD 56,000 - 101,000; Full time

Job summary

Centene Corporation is seeking a Quality Improvement professional to lead performance improvement initiatives focused on clinical quality and measure outcomes. The role supports NCQA/HEDIS activities, accreditation readiness, and delegated vendor coordination.

The position emphasizes policy development, training, and audits to ensure compliance with state and federal requirements. Remote work within the continental United States is supported.

Qualifications

• Bachelor’s degree in Business or a related field, or equivalent experience.
• At least 3 years of related quality improvement experience.
• Experience with NCQA/HEDIS preferred.

Responsibilities

• Develop and coordinate delegation oversight mechanisms and act as liaison for the Plan with Corporate Delegation Oversight.
• Develop and maintain accreditation readiness schedule.
• Create policy and procedures to support accreditation activities.
• Conduct training and education programs for Plan, provider network, 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 and coordinate corrective action plans to ensure compliance with all state, federal, contract and accreditation requirements.

Skills

Quality improvement

HEDIS

NCQA

Education

Bachelor's degree in Business or related field

Job description

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT

**Applicants for this role have the flexibility to work remotely within the continental United States. To support the needs of the business, preferred schedule is based on Eastern Standard Time zone.**

Position Purpose: 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.
• Creates policy and procedures to support accreditation activities.
• Conduct training and education programs for Plan, provider network, 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 and coordinate corrective action plans to ensure compliance with all state, federal, contract and accreditation requirements.

Education/Experience: Bachelor’s degree in Business, related field or equivalent experience. 3+ years of related quality improvement, HEDIS and/or NCQA experience.Pay Range: $56,200.00 - $101,000.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act