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Health Plan Accreditation Analyst Senior Job

Date: Jan 13, 2019

Location: Eagan, Minnesota, US, 55122

Company: Blue Cross and Blue Shield of Minnesota

For more than 80 years, Blue Cross and Blue Shield of Minnesota has been passionate about improving health. We provide quality, cost-effective health plans and innovative programs that make a healthy difference in people’s lives. Blue Cross is the largest health plan based in Minnesota, covering nearly 3 million members in the state and across the country. We strive to help all Minnesotans overcome the barriers to good health.



 



We offer our employees a comprehensive benefits, compensation and total rewards package to keep you and your family healthy and to secure your financial future. Our Employee Resource Groups help us advance health equity while promoting a diverse and inclusive work environment. Join us and make a healthy difference in people’s lives through the work you do every day. Together, we'll make Minnesota a better place to live — and a healthier one.


Description Summary

This position is responsible for working closely with leadership, leading cross-functional, cross-divisional teams, and partnering with external entities to achieve accreditation readiness, providing in-depth knowledge of accreditation requirements. The incumbent will provide business area consulting, assess organizational processes and policies, gather and annotate documents, provide feedback and evaluate progress, collect data and conduct analyses, and drive process improvement to achieve desired outcomes within tight deadlines. In addition, this position may participate in the coaching, mentoring, and training of other employees.


Accountabilities


  1. Establish and maintain a comprehensive understanding of new and existing accreditation standards, impacting multiple areas of the organization.

  2. Monitor, analyze and research requirements, obtain accreditation consulting support or policy decisions as needed to establish required business practices.

  3. Understand key relationships between accreditation standards and laws, regulations, and contract requirements.

  4. Establish and maintain relationships with business leaders and subject matter experts. Serve as a consultant and educator, providing guidance to multiple departments and stakeholders on accreditation requirements. Respond to business inquiries on accreditation matters.

  5. Collect, compile, analyze, interpret and annotate documentation for accreditation evidence, including support in preparing files for review. Identify and report on gaps and collaborate with business partners to ensure full compliance with accreditation standards. Prepare accreditation evidence in compliance with challenging deadlines to ensure timely document submission.

  6. Design methods to meet accreditation requirements and assist business leaders in evaluating and determining the best approach. Develop and/or contribute to policies, contract language, member and provider communications as required.

  7. Manage quality improvement processes including workgroup facilitation, survey design, data analysis, action planning, prioritization, performance monitoring and report writing for continuous improvement activities.

  8. Design, develop and use standardized templates and procedures in collaboration with team members and business partners to manage accreditation process and to create a comprehensive and proactive approach to the Quality Improvement Program and accreditation readiness. Maintain accurate and organized documentation.

  9. Support the Quality Improvement Program oversight committees, including contributing to agenda planning, committee presentations, accurate and comprehensive meeting minutes and follow up. Perform additional activities as required to support the accreditation process, the Quality Improvement Program, and/or quality department activities.


Requirements


  • Bachelor’s degree in business, health care, law, technology or other related field with 7 years of related work experience, or 11 years of related work experience in lieu of a degree.

  • Prior health plan experience, or experience in compliance, audit, accreditation, quality improvement or other field requiring detailed analysis, critique or comparison.

  • Excellent critical analysis skills.

  • Detail orientation, with the ability to compare business practices against a set of detailed standards, evaluating compliance, recommending improvement strategies, and producing accurate records and documentation.

  • Data analysis skills and experience.

  • Proven ability to define problems, collect and analyze data, and transform into project-level strategies.

  • Excellent continuous quality improvement and/or project management skills, with experience in team facilitation.

  • Ability to deal with ambiguity and design and develop new structures and processes.

  • Creative problem solving skills, adapting approach as needed. 

  • Demonstrated ability to work independently and make decisions as needed, with a track record of achievement.

  • Organized and able to manage against challenging deadlines.

  • Strong collaboration and relationship building skills, including the ability to work with a wide variety of people and personalities, and effectively facilitate group discussions and decision-making.

  • Articulate communicator with excellent verbal and written communication skills and ability to create professional presentations and clearly present complex information.


Preferred Requirements


  • NCQA accreditation experience.

  • Prior health plan experience.

  • Clinical credential or background.

  • Bachelor’s degree in business, health care, law, technology or other related field or equivalent additional years of experience.



#BCBSMN  #LI-JS1


FLSA Status

Exempt

Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association


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