We are looking for a Director, Accreditation to join us in leading our organization forward.

McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives. 

McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive.   As an employee MIG, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

McLaren Health Plan is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members.  Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org

MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs.  Learn more about MDwise, Inc. at https://www.mdwise.org/

Position Overview:  Responsible for acquiring, maintaining, and maximizing NCQA Health Plan and Health Equity Accreditation and other required accreditations across multiple lines of business and applicable entities. Collaborates with business leaders and stakeholders to meet or exceed accreditation standards, and to address opportunities for improvement across standards.  Serves as a liaison between the Plans and NCQA guiding the Plans on NCQA policies and procedures, negotiates the survey process as well as HEDIS/CAHPs procedures and standards with NCQA.  Plays a key role in NCQA survey administration tasks, including scheduling, application, and submission of Interactive Review Tools.  Provides regular updates to senior leadership on accreditation progress and any identified areas of improvement.

Michigan or Indiana Residency Preferred. 

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

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Qualifications:

Required:

Bachelor’s degree in nursing, health care administration or health related field. Three years (3) NCQA accreditation oversight experience including HEDIS oversight and CAHPs oversight. Five years (5) experience in a progressively more responsible leadership role in quality management operations including three (3) years’ experience in a management role leading or assisting in all phases of effective supervision.

Preferred:

Master’s degree in nursing, health care administration or related field. Valid State of MI and/or State of IN Nursing license. Five years (5) NCQA accreditation oversight experience, HEDIS oversight, and CAHPs oversight within a Health Plan setting. Five years (5) experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions. Additional Information Schedule: Full-time Requisition ID: 24008288 Daily Work Times: 8:00 am - 5:00 pm Hours Per Pay Period: 80 On Call: No Weekends: No