Mgr., Quality & Accred-PCHP

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

PRIMARY PURPOSE Parkland Community Health Plans (PCHPs) Manager, Quality & Accreditation oversees the development, implementation, and coordination of efforts and processes necessary to meet all National Committee for Quality Assurance (NCQA) accreditation requirements. Being the subject matter expert, the manager leads educative efforts and trains staff on matters related to NCQA accreditation. Continues to audit and train on new standards and oversees the regular reporting and re-certifications for NCQA.

MINIMUM SPECIFICATIONS

Education - Bachelors degree in Health Administration, Nursing, Business or a Healthcare related field.

 

Experience

- Five years of experience in the healthcare field.

- Three years of experience in NCQA/URAC accreditation.

- Five years of experience in managed care.

 

Equivalent Education and/or Experience

- May have an equivalent combination of education and a minimum of three years of experience to substitute for both the education and the experience requirements.

 

Certification/Registration/Licensure

- Must have Federal Emergency Management Administration (FEMA) course certification for IS-700.B: An Introduction to the National Incident Management System (NIMS) or obtain within 30 days of placement in role.

- Must have Federal Emergency Management Administration (FEMA) course certification for IS-100.C: Introduction to the Incident Command System (ICS 100) for Healthcare/Hospitals or obtain within 30 days of placement in role.

- Must have Federal Emergency Management Administration (FEMA) course certification for IS-200.HCA: Applying ICS to Healthcare Organizations (ICS 200) or obtain within 30 days of placement in role.

- Project Management Professional (PMP) certification is preferred.

 

Skills or Special Abilities

- In-depth knowledge of NCQA health plan standards, policies and procedures.

- Strong critical thinking skills.

- Excellent project management skills.

- Strong organizational and planning skills.

- Must be able to lead efforts across the organization and work with all departments.

- Ability to meet strict and rigorous internal and governmental reporting requirements and deadlines.

- Highly organized with great attention to detail.

- Strong interpersonal and prioritization skills.

- Excellent verbal and written communication skills that are effective at all levels.

- Demonstrated high degree of personal integrity and ethical standards.

- Proficient in Microsoft Excel, Power Point, and Word applications.

 

Responsibilities

- Serves as point of contact for NCQA accreditation entities and partners to ensure compliance with accreditation requirements.

- Leads activities to prepare the organization for NCQA accreditation.

- Serves as the subject matter expert for applicable accreditation standards.

- Develops tools and metrics to determine accreditation risks and identifies opportunities to mitigate those risks.

- Compiles information related to accreditation monitoring activities for internal use and external audits and maintains relevant records.

- Assists with the development and maintenance of all required annual metrics and quality program documents serving as the accreditation NCQA documentation requirements

- Collaborates with quality teams, utilization management teams, and other departments on accreditation and quality improvement initiatives.

 

Job Accountabilities

1. Identifies and analyzes the design of jobs, work processes, work flows, etc. for the area and implements appropriate changes to improve effectiveness, productivity, and efficiency that support the overall goals of PCHP.

2. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.

3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding.

4. Develops and monitors annual budgets that ensure the department has the necessary funds to carry out the goals and objectives that have been established for the department.

5. Develops, implements, monitors, and revises annual goals and objectives for the department that support the missions and objectives of PCHP.

6. Selects, trains, schedules, motivates, supervises, and evaluates employees making recommendations for disciplinary actions up to and including termination, to ensure maximum utilization of individual and group capabilities. Ensures that assigned employees receive opportunities to further their knowledge.

Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.

Posted
09/24/2020
Salary Range
$68,000.00 - 121,000.00
per Year
Salary range estimated by
Location
Dallas, TX 75201, US