You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
Ensure compliance with accreditation requirements and conduct routine readiness assessment and evaluation of policies and procedures, processed and records.
- Oversee the health plan NCQA preparations for accreditation surveys.
- Educate the health plans on NCQA and/or Center for Medicare/Medicaid Services (CMS) standards and requirements.
- Evaluate compliance of the corporations Medicare plans with NCQA Health Plan and SNP standards and reporting requirements.
- Lead policy and procedure documentation reviews for the health plans based on NCQA standards.
- Develop readiness assessment schedules, conduct accreditation audits and ensure changes to the standards are incorporated.
- Oversee the development of organization-wide initiatives to support accreditation.
- Maintain work processes to meet the latest NCQA/URAC accreditation standards.
- Assist with training and education development to promote accreditation standards.
Education/Experience:
Bachelor’s degree in Nursing, Healthcare Administration, related field or equivalent experience. 4+ years of quality improvement, regulatory compliance and/or auditing experience. Previous experience as a lead in a functional area, managing cross-functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
License/Certification:
Current state nursing license RN, LPN or LVN preferred. Valid driver’s license.
Pay Range:
$84,300.00 - $151,700.00 per year.
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. Total compensation may also include additional forms of incentives.
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.
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