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General Purpose of Job:The Accreditation Coordinator is responsible for the management of Accreditation and Re-Accreditation activities for Driscoll Health Plan encompassing all lines of business and/or specific programs. This position coordinates the analysis, development, implementation and maintenance of processes related to accreditation standards; including data collection and process evaluations to monitor compliance with those accreditation requirements and associated Federal and State regulatory requirements. The Accreditation Coordinator prioritizes projects, coordinates action plans, and monitors/analyzes results for accreditation projects, consistent with the organization and system strategic goals and initiatives. This position collaborates with the Compliance Department for interdepartmental Audit activities to streamline end receiver requests in support of evidentiary compliance.
Essential Duties and Responsibilities:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.
- Maintains utmost level of confidentiality at all times.
- Adheres to health system and health plan policies and procedures.
- Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
- Responsible for overall program management of the Health Plan Accreditation in collaboration with the Quality Division Leadership.
- Establishes organizational program that supports a continuous readiness culture related to accreditation surveys.
- Provides ongoing monitoring of health plan departmental processes for continuing compliance with accreditation standards.
- Performs gap analysis, as indicated, to determine needs for implementation of new standards and the impact to various departments across the organization.
- Provides project management for reaccreditation and/or inclusion of new lines of business, or others as deemed appropriate.
- Coordinates inter-departmental activities in the health plan and within the health system to optimize continued compliance with Health Plan Accreditation, including timely, accurate submission of materials.
- Collaborates with project management in the oversight of key quality metrics and quality/performance improvement projects/initiatives associated with Accreditation as indicated.
- Provides training and development consultation for accreditation standards.
- Other duties as assigned.
Education and/or Experience:- Bachelor's degree from four-year college or university in healthcare or other business-related field.
- Master's degree (M. A.) or equivalent in a related healthcare field preferred.
- At least 5 years' experience in managed care or related field.
- At least 5 years' experience with Health Plan Accreditation or related experience.
Certificates, Licenses, Registrations:- Certification in Healthcare Compliance; Current or within 6 months of hire.
- Preferred: Certification in Healthcare Compliance (CHC) from the Health Care Compliance Association (HCCA), Certified Healthcare Auditor (CHA) from the American Institute of Healthcare Compliance (AIHC), and/or Certified Internal Auditor (CIA).