Job Description:
The NCQA Clinical Quality manages the accreditation process for Select Health, ensuring compliance with NCQA Health Plan, Utilization Management and Health Equity Standards. This role involves working closely with internal clinical departments and leadership to maintain compliance, implement best practices, and ensure continuous readiness for NCQA accreditation.
Essential Functions
- Maintain current NCQA requirements and standards, ensuring compliance and readiness for accreditation, which validates the organization's commitment to quality.
- Assess audit readiness, identify gaps, develop corrective action plans, and educate diverse teams on NCQA standards to support SH departments.
- Utilize analytic tools and data to drive quality improvement and measurement, ensuring quality issues are addressed promptly and effectively.
- Provide ongoing training and education to ensure internal departments understand and implement NCQA compliance requirements.
- Conduct periodic and ad hoc audits to validate compliance, provide feedback, and manage corrective action plans.
- Prepare application submissions, facilitate evidence uploads, and respond to auditor inquiries for accreditation management.
- Monitor non-compliance events, report to NCQA, and communicate updates to internal department leadership.
- Identify and address inequities, promoting diversity, equity, inclusion, and belonging, ensuring quality care is accessible to all, aligning with NCQA's Health Equity Standards.
Required Qualifications
- Bachelor’s degree in Nursing (BSN) or other clinical degree from an accredited institution.
- RN or clinical license/certification.
- Clinical experience, project management or quality improvement experience, data analysis, and working in dynamic environments.
Preferred Qualifications
- Master’s degree in Nursing or other clinical degree from an accredited institution.
- Health plan experience, knowledge of NCQA standards, consulting within healthcare, and working with senior leadership.
- Analyzing healthcare data, conducting audits, and familiarity with federal and state healthcare regulations.
Skills
- Audit and Review
- Results-Oriented
- Communication (Verbal and Written)
- Problem Solving
- Analytical Thinking
- Time Management
- Quality Assurance
- Collaboration and Teamwork
Physical Requirements:
Physical Requirements
- Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
- Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
- Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
Location:
SelectHealth - Murray
Work City:
Murray
Work State:
Utah
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$38.77 - $59.82
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits package here.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.
All positions subject to close without notice.
