Remote Quality & Accreditation Manager (URAC/NCQA)

WNS Global Services; Oregon; Híbrido; USD 100.000 - 125.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Dental insurance

Vision insurance

Paid time off

401(k) with company match

Life and AD&D Insurance

Employee Assistance Program

Descripción de la vacante

WNS Global Services, part of Capgemini, seeks a RN Leader to oversee the Quality Management Program in a healthcare setting. You will lead accreditation efforts with URAC/NCQA, drive KPI development, and coordinate audits to ensure compliance and continuous improvement.

Candidates should have nursing qualifications, leadership experience, and knowledge of CMS/state utilization guidelines. This role offers remote work within the United States and a comprehensive benefits package.

Formación

• Graduate of an accredited nursing program with active RN license.
• 3+ years of quality, audit, or accreditation experience in managed care or health plans.
• 2+ years of leadership experience managing teams and initiatives.
• Experience with URAC and NCQA accreditation standards preferred.
• Knowledge of Medicare/Medicaid utilization management regulations.

Responsabilidades

• Lead the Quality Management Program with annual evaluation and continuous improvement initiatives.
• Identify risks and develop corrective action plans with monitoring and escalation.
• Oversee quality audits for clinical and physician review activities.
• Ensure findings are supported by standardized methodologies and regulatory requirements.
• Maintain readiness for accreditation surveys and regulatory reviews.

Conocimientos

Leadership

Communication

Critical thinking

Organizational skills

Team collaboration

Educación

RN license

BSN preferred

Descripción del empleo

WNS Global Services, part of Capgemini, seeks a RN Leader to oversee the Quality Management Program in a healthcare setting. You will lead accreditation efforts with URAC/NCQA, drive KPI development, and coordinate audits to ensure compliance and continuous improvement.

Candidates should have nursing qualifications, leadership experience, and knowledge of CMS/state utilization guidelines. This role offers remote work within the United States and a comprehensive benefits package.