Health Plan Accreditation & Compliance Lead

EmblemHealth, Inc.; New York (NY); Remote; USD 68.000 - 119.000; Vollzeit

Zusammenfassung

EmblemHealth, Inc. in New York seeks a qualified lead to oversee accreditation and regulatory activities, including NCQA, CMS, DOH, and other bodies relevant to the Plan. You will implement strategies to improve operational performance and ensure ongoing compliance across departments.

You will train stakeholders, coordinate survey and audit preparations, monitor documentation, and present findings to quality committees. Strong project management and communication skills are essential.

Qualifikationen

• Bachelor’s degree in health care, business, or related field.
• 4–6+ years managed care experience including 3 years accreditation or regulatory experience.
• Management/project management experience.
• Detailed knowledge of accreditation processes, policies, standards, and requirements.

Aufgaben

• Evaluate compliance with accreditation and regulatory requirements and monitor documentation.
• Identify deficiencies and recommend solutions for updated standards.
• Ensure full compliance and present reports to quality committees.
• Assess policies and revise procedures to meet accreditation standards.
• Train stakeholders in accreditation requirements and processes.
• Coordinate accreditation and regulatory readiness activities; interface with staff and auditors.

Kenntnisse

Communication skills

Project management

Leadership

Problem solving

Analytical skills

Negotiation

Team collaboration

Judgment

Adaptability

Conflict management

Stakeholder management

Strategic planning

Ausbildung

Bachelor's degree

Master's preferred

Tools

MS Office

Jobbeschreibung

EmblemHealth, Inc. in New York seeks a qualified lead to oversee accreditation and regulatory activities, including NCQA, CMS, DOH, and other bodies relevant to the Plan. You will implement strategies to improve operational performance and ensure ongoing compliance across departments.

You will train stakeholders, coordinate survey and audit preparations, monitor documentation, and present findings to quality committees. Strong project management and communication skills are essential.