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Accreditation Specialist

Apply now Job no: 495614
Recruiter: Allison Plummer
Hiring Manager: Shelley Collins
Salary Grade: I-8
Work type: Regular
Location: Omaha, Nebraska
Categories: Administration, Audit, Project Management

Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company; we exist to be there for people in the best and hardest moments of their lives.

Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it!

As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

What you'll do:

  •  Establishes and maintains audit program by collecting & analyzing operating information & conducting mock URAC audits
  • Collaborates interdepartmentally to help ensure URAC policies and procedures adhere to URAC standards, updating policies when necessary
  •  Facilitates URAC compliant training, as needed
  • Stays apprised of any URAC standards affecting accreditations
  • Subject matter expert on URAC accreditation standards and programs
  • Leads special projects and assists in quality improvement projects
  • Works with HEDIS and other performance measures as indicated
  • Partner with management to remove impediments, resolve conflicts and issues that occur to ensure project and program velocity
  • Monitor metrics defined by the leadership to measure, develop and execute plans to improve maturity
  • Develop detailed project execution plans; track project progress, budget, milestones and quality; Effectively communicating to program and project stakeholders

To be considered for this position, you much have:

  • Bachelor's Degree
  • 3-5 years of experience

An equivalent combination of education and experience may be substituted for this requirement.

The ability to meet or exceed the attendance and timeliness requirements of their departments.

The ability to work well in a team environment, and be capable of building and maintaining positive relationships with other staff, departments, and customers.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

The strongest candidates for this position will also possess:

  • Master's Degree
  • Experience with Insurance Health Plans
  • Experience with quality auditing
  • Familiarity with HEDIS
  • Experience with Project Management

Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.

We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.

Blue Cross and Blue Shield of Nebraska is an Equal Opportunity /Affirmative Action Employer - Minorities/Females/Disabled/Veterans

 

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