Manager of Accredidation

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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.

The Manager of Accreditation will lead a team which is responsible to attain and maintain NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The Manager will work closely with cross-functional teams to ensure compliance with NCQA standards, manage team workload and work assignments, and play a key role in NCQA survey administration tasks.

Our Investment In You:

• Full-time remote work
• Competitive salaries
• Excellent benefits
  
  

Key Functions/Responsibilities:

• Works closely with cross-functional teams to ensure compliance with NCQA standards, manage team workload and work assignments, and play a key role in NCQA survey administration tasks
• Acts as SME, providing guidance and support on complex accreditation questions
• Develops and maintains roadmap to ensure timely completion of accreditation requirements
• Provides regular updates to SLT on accreditation progress and any identified areas of improvement or associated risk
• Leads NCQA survey administration tasks, including scheduling, applications, and submission of Interactive Review Tools
• Creates and manages Plan-wide awareness of the value of accreditation and ensures that it is reflected in the company’s ongoing processes and procedures.
• Supports cross-functional efforts to maintain ongoing practices in support of re-accreditation efforts and other quality based projects and initiatives.
• Key NCQA Accreditation point of contact to NCQA directly, as well as other governing bodies.
• NCQA Accreditation SME for internal staff at all levels.
  
  

Supervision Exercised:

• 3-5 Direct Individual Contributors
  
  

Supervision Received:

• General supervision is received weekly.
  
  

Qualifications:

• Bachelor’s degree or an equivalent combination of education, training, and experience in related field.
• Minimum five (5) years of experience in Accreditation, with a proven track record of success in NCQA Health Plan Accreditation and/or NCQA Health Equity Accreditation
• Strong understanding of NCQA health plan Accreditation standards and survey administration
• Strong leadership experience, critical thinking/problem solving skills, and a strategic mindset.
  
  

Preferred/Desirable:

• Master’s degree in a related field.
• Clinician, certified in nursing or behavior health preferred.
  
  

Experience:

• Minimum five (5) years of experience in Accreditation
  
  

Preferred/Desirable:

• Demonstrated competence in successful interactions with accrediting bodies.
• Previous project management experience.
  
  

Certification Or Conditions Of Employment:

• Pre-employment background check
  
  

Competencies, Skills, And Attributes:

• Ability to facilitate process improvement efforts.
• 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

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