NCQA Accreditation Consultant

About the job

High performing consulting firm wants consultants passionate about the NCQA and URAC standards to work remotely. No travel needed. Please note that this application requires a video submission. You will only be considered if you follow the video submission requirements. If a resume is received without a video, your application will be rejected.

Role Description

This is a contract remote role for an NCQA Accreditation Consultant at MHR. The Consultant will work 20 – 30 billable hours a week and partner with clients to evaluate current compliance, identify gaps, mentor and coach 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

• MUST have at least two cycles 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 all the standards, assisted business owners in meeting requirements, and prepared documents for submission (highlighting, bookmarking and pdf development).
• Hands-on also means conducting review of health plan accreditation files: appeals, denials, and complex case management files and credentialing and recredentialing files against the NCQA standards for all product lines: commercial, Medicaid, Medicare, Marketplace.
• PLEASE do not apply if these basic and critical requirements are not met.
• Hands-on also means involvement for at least two cycles of accreditation from submission of application to submission of the survey documentation and file review, including strategizing and prioritizing activities needed to complete the process for commercial, Exchange, Medicare and Medicaid health plan lines of business.
• For clinicians, hands on involvement with other NCQA products, such as health equity, population health programs, UM accreditation, QI, case management accreditation capability with long term services and supports distinction a plus.
• For non-clinicians, involvement with credentialing, quality improvement, network management, member experience required and work with health equity 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.
• Ability to provide detailed direction to clients at different levels in their knowledge and organization (line staff/managers/directors/VPs) on gap mitigation, readiness for surveys and creative methods to remove organizational barriers.
• Demonstrated capability to develop detailed documentation to meet standards' requirements (such as for analytical standards), 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.
• Developed 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.
• Able 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.
• And desire to work collaboratively in a team environment.
• Teachable and an ongoing learning mentality.
• Commitment to work 20 - 32 billable a week.

Company Description

Managed Healthcare Resources, Inc. (MHR) is a 35-year-old boutique consulting firm specializing in NCQA accreditation. MHR consultants are passionate about NCQA accreditation and continuous quality improvement, guiding organizations to meet NCQA requirements for almost all 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.

Application Instructions

To apply, please complete the following short application (including uploading your resume and video, answering the below questions). The application link can found by clicking the "Apply Today" button on our website: https://www.managedhealthcareresources.com/careers-page. No candidates will be chosen without a video submitted to prescreen. The video must answer the following questions:

1. What excites you the most about the ability to work with MHR?
2. What stood out to you/resonated with you about the website information?
3. Tell me about a time that you took an organization through NCQA health plan accreditation survey in the last six years and what the result was.
4. How do you manage competing priorities? Share a real-world example of how you managed the priorities under pressure.