NCQA Accreditation Specialist

Who We Are 

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. 

We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today. 

Who You Are 

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change.  

Your Role 

As an Accreditation Specialist with Evergreen Nephrology, you are responsible for operations compliance with accreditation and regulatory requirements regarding NCQA.  You will be responsible for developing, coordinating, integrating, and monitoring accreditation activities and initiatives in compliance with state and federal regulations.  

Primary Functions

• Collaborate with internal partners to collect data and develop compliance documents/evidence for successful accreditation surveys  

• Monitor and maintain comprehensive compliance documents and evidence to ensure successful accreditation survey and ensure adherence to NCQA standards  

• Maintain up-to-date records.  

• Educate staff across the organization regarding accreditation standards and requirements  

• Evaluate current practices and identify compliance gaps and recommend solutions to close gaps  

• Prepare training materials, reports, and materials to support compliance  

• Coordinate accreditation surveys and serve as a point of contact during surveys to ensure all requirements are met  

• Act as subject matter expert, handling complex assignments, and may assist training/mentoring department staff  

• Regular and reliable attendance  

• Other duties consistent with this role, as assigned. 

Required Qualifications 

• Bachelor’s degree and 4 years of experience in managed care environment OR 6 years of work experience in managed care environment 

• Managed care environment experience includes one or more of the following areas: audit, health plan operations, compliance or legal 

• 2 years Accreditation experience (i.e. NCQA, URAC, Joint Commission, CMS) to include managing survey/review experience  

• In-depth knowledge of NCQA standards and accreditation processes  

• Knowledge of health care regulatory and legislative process; experience reading and interpreting legislation  

• Experience using Total Quality Management (TQM) / Continuous Quality Improvement (CQI) concepts  

• Knowledge or experience reviewing accreditation standards and evaluating level of compliance, identifying challenges and proposing solutions  

• Knowledge or experience monitoring compliance and managing evidence documents  

• Verbal and written communications skills including training skills  

• Research and analytical skills  

• Experience managing multiple complex priorities, often with limited time frames  

• Detail oriented with strong organizational skills and experience meeting deadlines   

• Intermediate skills with MS Office Suite of products including Outlook and Teams 

• Able to work effectively in a primarily remote environment: 
  • Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
  • Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
  • Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information  

Preferred Qualifications 

• Project Management (PMP) certification  

• Ability to think critically and suggest innovative solutions  

Compensation 

The pay range for this role is $75,000 to $85,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.   

This role is also eligible for an annual bonus.  

Benefits  

Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect: 

• Paid time off starting at 4 weeks for full-time employees 

• 12 paid holidays per year 

• Medical, dental, vision and life insurance, including an HSA with employer match 

• Reimbursement for continuing medical education for eligible roles 

• A 401(k) program where Evergreen matches up to 4% of contributions after six months of tenure

• Paid parental leave 

• A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology 

Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws. 

If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at [email protected].