Quality Accreditation Coordinator
On-siteDoral, Florida, United States
Job Summary
Coordinate quality improvement, regulatory compliance, and NCQA accreditation activities by reviewing and analyzing data across claims, authorizations, grievances, and case management. Support the Director of Quality Operations with QOC investigations, audit preparations, and evidence file documentation for external surveys. Collect performance indicator reports, benchmark narratives, and supporting documentation to drive continuous quality improvement initiatives and process recommendations. Interpret data for senior management decision-making and assist with accreditation-related education while ensuring data accuracy and timely reporting. Monitor quality metrics, outcomes, and strategic planning initiatives to address data integrity issues. Work onsite Monday through Friday in a fast-paced, highly regulated environment, with flexible hours and potential overtime as needed.
Required Qualifications
- HS Diploma required or Associate's degree in Healthcare Administration, Nursing, or related field
- 2+ years of experience in managed care, Medicare, Medicaid, or health plan setting
- Bilingual in English and Spanish
- Experience with NCQA health plan accreditation standards
- Knowledge of federal regulations and industry standards
- Strong data analytical and problem-solving skills
- Excellent communication and documentation abilities
- Attention to detail with a focus on data integrity
- Experience using Microsoft applications
- Expert knowledge in Excel
- Must be able to frequently lift up to 10 pounds and occasionally lift and/or move up to 25 pounds
- Must be able to stand and walk
- Must have close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus
- Must be able to work in a fast-paced environment
- Must have a demonstrated ability to juggle and prioritize multiple competing tasks and demands
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