Director, Accreditation Programs

Date: Sep 10, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8012 

 

Position Summary/Position

 

At Inland Empire Health Plan (IEHP), we believe the highest quality of care should be delivered to all in the Inland Empire.  We are thinking beyond the way Quality is viewed today; we believe it should be holistic and transformative.  IEHP’s accreditation programs serve an important role in achieving IEHP’s Quality goals.
Reporting to the Senior Director of Quality Systems, the Director, Accreditation Programs is responsible for:
- Leading health plan accreditation activities to ensure that IEHP is always NCQA survey ready 
- Working collaboratively with key stakeholders to ensure all systems and processes are coordinated to meet accreditation requirements.
- Providing operational and strategic leadership to support IEHP’s strategic goals, with special focus in the area of quality.  
- Ensuring that all quality program activities meet compliance standards as outlined by IEHP’s regulatory agencies (NCQA, CMS, DHCS, DMHC).
 

Major Functions (Duties and Responsibilities)

 

1. Direct health plan accreditation activities to ensure that IEHP is always NCQA survey ready.  This role is accountable to ensuring organizational readiness for all applicable NCQA accreditation standards that IEHP intends to gain or maintain.  IEHP’s accreditations currently include Health Plan Accreditation (multiple products), Health Equity Accreditation, LTSS Distinction.  Serve as the primary point of contact for NCQA audit-related activities.
2. Work in a highly collaborative environment, ensuring accreditation standards and guidelines are well understood, transparent and adopted across the organization, with special attention to facilitate standards that impact cross functional departments.
3. Develop and implement IEHP’s Quality Management Program and Work Plan, working collaboratively with leaders across the organization in support of IEHP’s goals of becoming a 5-star rated health plan.
4. Lead a high functioning, multi-disciplinary team to achieve IEHP’s Quality Management program and work plan deliverables and serve as partners across the organization in support of quality management and accreditation goals.  
5. Direct the Quality Management Team to ensure high-productivity, high-quality output, and a commitment to strong customer service.
6. Ensure Quality Management protocols and operations are aligned to achieve and maintain accreditation status and regulatory compliance.
7. Oversee IEHP’s Quality Committees and ensure compliance with regulatory requirements and optimize meeting structure to encourage meaningful collaborations and actions driving quality outcomes. The participants of these Committees include internal Team Members and external/network/community partners.
8. Develop methods to assess current practices at IEHP in relation to Quality Management programs and implement process and system improvements.
9. Review Quality Management data to identify opportunities for improvement and make recommendations to senior leadership for organization-level priorities, to support IEHP’s goal of achieving a 5-Star rating in health plan quality.  
10. Establish and maintain effective working relationships with others throughout the organization.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Five plus (5+) years of significant experience managing regulatory and accreditation programs at a health plan.  Five (5) years leading diverse teams with a focus on quality management programs.

Preferred Experience

Education Qualifications

 

Bachelor’s degree in Business or a Healthcare related field from an accredited institution required.

Preferred Education

 

Master’s degree in Business or Healthcare related field from an accredited institution preferred.

Professional Certification

Professional Licenses

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement

 

Working knowledge of quality management regulatory requirements from NCQA, CMS, DHCS, and DMHC required. 

Skills Requirement

 

Excellent written and verbal communication and interpersonal skills. Strong organizational skills and computer proficient.

Abilities Requirement

 

Ability to establish and maintain effective working relationships with others. Ability to clearly present issues, communicate the approach taken to analyze the issue, and clearly express the results to a wide variety of audiences. Ability to handle multiple projects. Strong attention to detail required. 

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. 

Work Model Location

Hybrid

Physical Requirements

Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Memory - FREQUENTLY
Understand and follow direction - FREQUENTLY
Regular and reliable attendance - CONSTANTLY
Keyboarding: 10-Key - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Keyboarding: Traditional - FREQUENTLY
Sitting - CONSTANTLY
Indoors - CONSTANTLY
Lighting - CONSTANTLY

 

Starting Salary: $153,670.40  - $195,936.00  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 7,000 and a team of more than 2,500 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles