We are seeking a dedicated URAC Accreditation Specialist to oversee and maintain the URAC accreditation process for our Medical Management programs, demonstrating our commitment to healthcare excellence.

Key Responsibilities:

• Serve as the URAC subject matter expert for Medical Management and organizational leadership.
• Develop and implement compliance tools, processes, and policies.
• Monitor data and metrics for compliance evidence.
• Educate staff on URAC standards and requirements.
• Identify compliance gaps and recommend solutions.
• Lead URAC accreditation site visits and reviews.
• Stay updated on regulatory changes and updates.
• Collaborate with leadership to translate standards into operational workflows.
• Develop training and reference materials for URAC compliance.
• Identify and address compliance improvement opportunities.
• Maintain accreditation readiness plans and tools.
• Track and report on accreditation and compliance metrics.

Requirements:

• Bachelor’s degree in Business, Health Care Administration, or related field (or equivalent education and experience).
• Minimum of 3 years of accreditation support experience (URAC, NCQA, CMS) in a Managed Care Organization or healthcare system.
• Experience managing onsite and virtual audits and surveys.
• Proficiency in interpreting regulatory, accreditation, and contractual standards.

Technical Skills:

• Knowledge of TRICARE programs, Managed Care concepts, healthcare delivery systems, URAC standards, HIPAA regulations, and Microsoft Office applications.
• Strong problem-solving and analytical skills.
• Excellent organizational and information management abilities.
• Capability to function effectively in a fast-paced environment.
• Customer-focused with strong empathy and communication skills.

Preferred Qualifications:

• Project Management experience or certification.
• Experience in data management, analytics, and report building.
• Experience in program and outcome assessments.

If you are a proactive, detail-oriented professional with a passion for ensuring compliance and improving healthcare outcomes, we encourage you to apply.