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Job Summary

Supports health plan accreditation for the initial phase and maintains existing health plan accreditation. Identifies areas of risks and opportunities to accomplish successful accreditation. Analyzes and measures the effectiveness of existing processes and helps to develop sustainable, repeatable, and quantifiable business process improvements.

Essential Functions

+ Ensure compliance with NCQA standards and guidelines, driving continuous improvement in accreditation efforts

+ Collaborate with internal teams to enhance quality programs and maintain accreditation requirements

+ Conduct mock audits, assessments and reviews to identify areas for improvement

+ Provide guidance, training and education on accreditation requirements and best practices

+ Assist in the preparation of reports and documents, as needed

+ Develop and implement strategies to optimize accreditation success and regulatory alignment

+ Identify and address compliance gaps and risks in current practices

+ Supports improvement activities with advanced project plans outlining measurable deliverables and milestones.

+ Assists with development of appropriate indicators and measures of performance including tools and strategies for ongoing performance measurement.

+ Develops concurrent data collection, analysis, dashboard/visual management and reporting tools for feedback to teams/departments, utilizing operational processes for improvement.

+ Drives continuous assessment and improvements for the processes within the business and assists stakeholders and process owners in prioritizing improvement opportunities related to accreditation.

Qualifications

Required

+ Bachelor's Degree or equivalent in a field closely related to operational improvement/process improvement/project management, health care, business administration, or related field

+ 2 years of relevant experience with the following:

+ Implementing successful, organization-wide operational improvement launches in the health care industry, quality improvement/facilitation, experience in an organization of size and complexity comparable to Corewell Health, health plan environment, computer experience and skills with all Microsoft Office 365 applications

+ Process improvement, project management, change management, and / or team leadership.

Preferred

+ Experience with all facets of NCQA accreditations

+ Knowledge of NCQA accreditation processes and standards

+ Planning, project management and organization skills

+ Ability to effectively communicate both verbal and in writing to all levels of the organization

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

+ Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here (https://careers.corewellhealth.org/us/en/benefits-new) .

+ On-demand pay program powered by Payactiv

+ Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

+ Optional identity theft protection, home and auto insurance, pet insurance

+ Traditional and Roth retirement options with service contribution and match savings

+ Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Continuing Care - 1239 E Beltline - Grand Rapids

Department Name

PH - Health Plan Quality

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8 a.m. - 5 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.