Kaiser Permanente Accreditation Specialist in Denver, Colorado
Under the direction of Director of Quality and Accreditation Oversight, responsible for Colorado Kaiser Permanente's regulatory and accreditation programs. Ensures continued high levels of performance with regulatory, accreditation, and internal requirements including but not limited to NCQA, DOI, Medicaid, DPHE, CMS, QHIC and board of directors. Provides leadership and oversight of development, documentation and implementation of a regional review and accreditation plan that includes auditing, coordination of multiple required program processes, such as quality improvement and utilization management activities, education and training.
Essential Functions: - Performs as the functional expert in field within KP of new governmental standards, requirements and regulatory environment to enable region to prepare strategies for future implementation. - Works in collaboration with Medical Group, regional departments and program office to ensure high level of performance with regulatory, accreditation and internal requirements and surveys e.g. NCQA, CMS, DOI, DPHE, QHIC and board of directors. - Serves as the key contact for the organization for NCQA. - Meets all required timeframes and deliverables as it relates to NCQA. - Ensures that the training activities incorporate all applicable KP policies, local, state and federal laws and regulations, and accreditation standards. - Employs expertise as a specialist in NCQA, CMS and other regulatory requirements. - Demonstrates knowledge of key influences impacting the business and implication. - Leads cross functional project teams.
Qualifications: Basic Qualifications: Experience - Minimum five (5) years of clinical experience that includes direct patient care. - Minimum three (3) years of professional experience in auditing, quality improvement, patient safety and accreditation. Education - Bachelor's degree required. License, Certification, Registration - Current license as a Health Care Clinical Professional, such as RN, Pharmacist, Physical Therapist, or other clinical care credential (LCSW, Occupational Therapist).
Additional Requirements: - Strong familiarity with federal and state regulations. - Knowledge of and experience with work processes/analysis techniques, database management, and decision support techniques, quantitative and statistical analysis. - Excellent oral and written communication skills, as well as interpersonal skills. - Demonstrates the ability to develop relationships throughout all levels of the organization. - Ability to lead by influence. - High ethics and integrity.
Preferred Qualifications: - Strongly prefer experience in a managed care setting. - Master's degree preferred.
COMPANY Kaiser PermanenteTITLE Accreditation SpecialistLOCATION Denver, COREQNUMBER 611094
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.