Quality and Accreditation Speciliast

Overview

Quality & Accreditation Specialist - Care Management at Comagine Health

Company: Comagine Health
Department: Care Management
Employment Type: Full-Time

About the Role

Comagine Health is seeking a Quality & Accreditation Specialist to support and advance our Care Management Quality Management Program. In this role, you will work closely with Care Management leaders and staff to lead accreditation and reaccreditation efforts while driving quality improvement initiatives that support excellent clinical and operational outcomes.

This position plays a critical role in leading accreditation standards, maintaining high-quality care management practices, and supporting continuous improvement across the department.

• Quality Management Program Support (20%)
  • Partner with the AVP of Care Management and the Manager of Quality & Process Improvement to lead and facilitate the Care Management Quality Management Program.
  • Coordinate quality management meetings, prepare and collect presentation materials, facilitate meetings, disseminate information, and document action items and meeting notes.
• Quality Improvement Initiatives (20%)
  • Track, monitor, and support (or lead) quality management actions and initiatives related to Quality Improvement Plans (QIPs) and other quality-focused projects.
• Policy & Program Documentation (30%)
  • Lead and coordinate annual updates to Care Management department policies and documentation.
  • Maintain and update program evaluations, quality management plans, care management program overviews, URAC standards documentation, and the Care Management Business Continuity Plan.
• Accreditation & Reaccreditation Leadership (30%)
  • Serve as Comagine Health's primary Point of Contact (POC) with URAC.
  • Lead and coordinate the URAC accreditation and reaccreditation process, including planning, scheduling, desktop submissions, and onsite visits.
  • Manage document submissions through the URAC web-based portal.
  • Collaborate with Care Management leaders to prepare annual URAC deliverables, update policies to meet standards, and respond to URAC requests and directives.

Education

• Bachelor's degree (BA/BS) required
• Advanced clinical degree from an accredited institution (preferred)

Licensure

• Current, active, unrestricted RN license required
• (May be substituted with additional years of relevant medical, dental, behavioral health, or healthcare experience)

Experience

• Minimum of 7 years of healthcare experience
• At least 2 years of experience with leading accreditation programs such as URAC, NCQA, or JCAHO

• Intermediate communication skills
• Intermediate interpersonal and relationship-building skills
• Intermediate professionalism, integrity, and reliability
• Advanced self-management skills
• Foundational knowledge of quality improvement and process optimization
• Intermediate project and program management skills
• Intermediate clinical knowledge