RN NCQA Accreditation Consultant

Job description Are you interested in having flexibility, be the authentic you, and work with knowledgeable and like-minded colleagues in an ethical environment and affect the care and service of millions of managed care members with your work? This position provides autonomy and mastery of the NCQA accreditation standards. This is only for those who wish to take some risk at leaving a W2 position for a 1099 independent consulting position. MBO Partners just released a State of Independence in America Annual Research Study. Among their findings is that, for more people, working independently allows them to be who they really are: to make work add up to more than a paycheck, and to build a sense of security, purpose, and personal growth. This is embodied in working at Managed Healthcare Resources. Company Description Managed Healthcare Resources, Inc. (MHR) is a 34-year-old boutique consulting firm specializing in NCQA accreditation. MHR is passionate about accreditation and continuous quality improvement, guiding organizations to meet NCQA requirements for most NCQA products. With a diverse team of very experienced consultants, most of whom are NCQA surveyors, we provide support at every stage of the accreditation process, from gap analysis to staff training and documentation development. Our vision is to “empower healthcare organizations to reach their fullest potential through successful NCQA accreditation, driving excellence and raising the bar in healthcare quality standards.” We empower our clients by coaching, mentoring, and transferring accreditation knowledge to staff to help them become as independent as possible. We work in a collaborative team environment while working independently. You must have the requisite skills when you come to work with us. You can read about us on our website at ManagedHealthcareResources.com. Please do not apply without reviewing our website to know who we are, what we do, and whether we reflect your values. Role Description This is a contract remote role for an NCQA Accreditation Consultant at MHR. The Consultant will work 25 – 30 billable hours a week and partner with clients to evaluate current compliance, identify gaps, mentor staff, develop strategies, and provide project management support if needed. Daily tasks include conducting file reviews, staff training on standards, and creating documentation to meet accreditation requirements within specified budgets. Formal onboarding and orientation provided, along with collegial and mentoring support of the consulting team. This opportunity is not a fill-in-the-gap until a traditional job presents itself or adjunct to a day job. This is a commitment to the consulting lifestyle and full time consulting, not an after your job and on weekends contract position. Qualifications • Ability to manage the NCQA health plan accreditation process for clients, including strategizing and prioritizing activities needed to complete the process for commercial, Exchange, Medicare and Medicaid health plan lines of business. • Experience with other NCQA products, such as health equity, population health programs. Capability with long term services and supports distinction a plus. • Current NCQA surveyor preferred, but non-surveyors accepted. • Possess strong analytical and critical thinking skills with great attention to detail - mandatory • Ability to conduct detailed evaluations of client documentation against NCQA standards. • MUST have at least three years of recent (2020-2024) hands-on experience with taking health plans through the NCQA health plan accreditation process. Hands-on means that you were directly involved in evaluation of documents against the standards, assisted business owners in meeting requirements, and prepared documents for submission (highlighting, bookmarking and pdf development). Hands-on also means review of all health plan accreditation files: appeals, denials, and complex case management files and credentialing and recredentialing files against the NCQA standards. PLEASE do not apply if these basic and critical requirements are not met. • Ability to provide detailed direction to clients at different levels in their organization (line staff/managers/directors/VPs) on readiness for surveys, gap mitigation and creative methods to remove organizational barriers • Develop detailed documentation to meet standards' requirements, if requested by client • Ability to conduct business in a manner that meets clients where they are in a non-judgmental fashion and mentor, coach and guide them to meet standards in a meaningful way. • Demonstrated experience in conducting work group meetings • Possess experience and the ability to educate, train and mentor individuals • Be self-motivated and able to work independently • Ability to meet client's and firm's timeliness requirements • Possess organization skills • Have ability to work with multiple clients on assignments with competing needs and timelines on both sides • Possess ability to identify issues early and proactively • Demonstrated ability to communicate in a clear, concise, directive, and efficient manner via emails, readiness assessments, and verbally • Ability and desire to work collaboratively in a team environment • Commitment to work 25 - 30 billable hours a week • Bachelor's degree in Healthcare Administration, Public Health, or related field accepted. A master's degree in health services, public policy, health services administration or business is a plus. Must have at least a moderate proficiency with Microsoft Office (Word, Excel, PowerPoint), ability to use Adobe for bookmarking and document manipulation, ease with web-based technologies, and have a computer and a backup computer, a telephone (usually your cell phone) and a secluded and lockable workspace for confidential discussions and protection of confidential and proprietary information. There is an extensive screening process, including NDA execution, pre-screening, exercises, completion of an extensive experience grid, a DISC assessment, and three interviews if the pre-screening requirements are met. Only those with the highest level of experience and knowledge of accreditation pass through to the interview process to work for what one client has called our “elite” consulting firm. Apply Job! Apply tot his job Apply To this Job