Vacancy Description
Position Summary
:The NCQA Specialist coordinates quality improvement activities and supports various functions within the scope of the Plan quality improvement program, working both independently and as a team member. The functions may include but are not limited to committee support; regulatory and accreditation standard adherence; delegation oversight; performance monitoring and assessment; data collection and analysis; and the continual advancement of the quality improvement process to achieve the Health Plan's goals of excellence.
Essential Functions and Responsibilities:
Accountable for assigned standards from National Committee for Quality Assurance (NCQA), which may involve oversight of delegated activities.
Works with Plan departments, such as Quality, Contracting, Provider Relations, Member Services, Appeals and Grievances, Pharmacy Services, Utilization and Medical Management, Credentialing, and other departments and delegates to ensu...
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