Posted On: 06-01-2018
Position Title: Clinical Manager of Accreditation Programs
Job Location: Twinsburg, OH
Contact: Kimberly Hamilton, Senior Recruiter: kshamilton@envisionrx.com
Apply Online: https://www.linkedin.com/jobs/cap/view/705292885/?pathWildcard=705292885&trk=job_capjs    OR EnvisionRXOptions:  https://envisionrx.com/OurDifference/WhoWeAre#Careers

 

IF YOU’RE LOOKING FOR A VISIBLY DIFFERENT HEALTHCARE CAREER IN ACCREDITATION WITH CONTINUOUS GROWTH AND CONTINUOUS REWARDS INCLUDING WORLD CLASS BENEFITS; THEN LOOK NO FURTHER!!

 

JOB DESCRIPTION: Clinical Manager of Accreditation Programs

The Clinical Manager of Accreditation Programs is the key driver for oversight and leadership of the organizations accreditation process for URAC and NCQA accreditation and certification. This position has direct reports.

 

Department:      Clinical

Supervisor:          Director Quality and Productivity

Exemption:        Exempt

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Manages the organization’s accreditation processes, ensuring compliance and training and various types of presentations to department personnel
  • Conducts regular reviews with appropriate staff and assists with revision of policies and procedures or standard operating procedures related to current accreditation standards.
  • Identifies and verifies compliance with established accreditation standards, recommending corrective action for any noted deficiencies through policy, training, or other administrative measures.
  • Reviews URAC and NCQA standards to ensure the organization remains in compliance with accreditation standards.
  • Functions as Subject Matter Expert (SME) of all aspects of the accreditation process, including proposed changes or amendments to the standards and assesses the impact of changes on current policies and procedures.
  • Organize, facilitate, and participate during evaluations with accreditation organizations.
  • Develop and maintain communication materials between EnvisionRxOptions and accreditation organizations.
  • Lead and conduct Team and Organizational committee meetings, related to the achievement and maintenance of applicable accreditation programs.
  • Work closely with business partners at all levels of the organization to understand the business, solve problems, and present recommendations to Team and Leadership partners.
  • Use critical thinking skills preparing material and presentations for the business in a way that adds value, is easily understood by others who may not have the same background or expertise, and improves the operational efficiency of the business.
  • Compare current organizational practices against accreditation standards and formulate plan for bridging identified gaps.
  • Ability to set strategy for achieving end goal of accreditation, while developing multiple individual tactics to meet set goal
  • Build and establish an effective and trusting partnership with the Operations Front Line and Leadership teams.
  • Develop and execute communication plans for all stakeholders and partners.
  • Other duties as assigned

REQUIREMENTS:

  • Bachelor’s Degree or equivalent work experience in lieu of degree
  • 3+ years’ experience in process improvement and operational excellence
  • 2+ years in project management or equivalent experience.
  • 2+ years of quality management or equivalent experience.
  • Thorough knowledge of URAC PBM and DTM accreditation standards, including periodic reporting requirements and required physical audits.
  • Demonstrated success dealing with uncertainty, ability to learn on the fly to understand, and solve new problems
  • Possess a high level of independent judgment and initiative required
  • Ability to communicate effectively in a manner that is clear, logical, and concise
  • Excellent interpersonal skills, including the ability to interact and influence at all levels of the organization
  • Highest level of attention to detail and the ability to manage multiple projects simultaneously, adjusting priorities as needed and meeting deadlines.
  • Ability to work extended hours, weekends and holidays pursuant with industry demands
  • Proficient in Microsoft Office and industry related software programs
  • Willingness to travel

PREFERRED QUALIFICATIONS:

  • Knowledge base and experience with National Committee for Quality Assurance (NCQA) accreditation, specifically applied to Pharmacy Benefit Management (PBM) activities
  • MBA or Master’s degree in related field
  • PMP certification

WORK ENVIRONMENT:

Includes a contact center environment, with exposure to excessive noise with minimal exposure to adverse environmental issues.

PHYSICAL REQUIREMENTS:

Ability to sit for prolonged periods of time.