Senior Quality Specialist (Accreditation)

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work / life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture.

What You'll Be Doing :

Put your passion where it meets purpose! Evolent attracts some of the brightest minds in health care. Surround yourself with talented, driven colleagues who share a passion for better health outcomes and a more connected care journey. We are hiring for a Senior Quality Specialist (Accreditation) to join our Quality Team. Join the Evolent Quality Department where we embrace new ideas, drive for compliance for accreditation success and challenge ourselves to deliver to meet all business needs in a collaborative, positive culture. We respect and celebrate individual talents, and team wins while working to achieve a constant state of accreditation survey readiness. This position supports the accreditation and quality functions for Evolent Health.

Collaboration Opportunities :

The Senior Quality Specialist for Accreditation role will work closely with the NCQA Manager in collaboration with multiple departments in meeting the accreditation document requirements. This role will work autonomously in ensuring compliance with accreditation requirements with ongoing education to leadership, staff and physician group.

What You Will Be Doing :

Serves as a member of the quality team. Supports the maintenance of a strong quality program and adherence to State, Federal, CMS, Accreditation (NCQA and / or URAC), and contractual requirements. Adherence to the organization's ability to be in a constant state of audit readiness.

Assists in the preparation of customer and external audits

Assists / leads with annotations and bookmarks for customer audits (i.e. policies and procedures, meeting minutes, other required materials / documents)

Assists / leads with gathering documents for accreditation audits

Assist leadership with finalizing documents for submission for accreditation

Facilitate meetings with internal stakeholders as needed

Assist with projects for gap analysis, compliance risk with accreditation standards

Assist with reviewing released accreditation standards, education as applicable

Assist with project management of documents, timelines for preparation of audits

Work collaboratively with quality team and leadership for delegation vendor oversight

Assist with review of vendor / delegate contracts and participates in pre-delegation

Assist with vendor / delegate annual oversight for accreditation requirements (P&Ps / document review)

Assists with policies and procedure review for accreditation requirements

Responsible in assisting with providing the data for the Monthly Operations Report (MOR) as applicable

Knowledgeable and / or SME in accreditation requirements

Any other duties as assigned by Manager or Quality leadership

Qualifications Required and Preferred :

• Work Experience 4+ years required in Quality or healthcare related field
• Education High School Diploma or college degree or higher-level education (tech / certification)
• Able to work independently
• Expertise in data management, data analysis, reports, and project management skills
• Strong working knowledge of Microsoft products and systems
• Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports
• Preferred Lean Six Sigma Certified or similar Quality certification

To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.

Technical Requirements :

We require that all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.

The expected base salary / wage range for this position is $78,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.