AD, Recognition Programs (Remote)

As part of the unit management team, this leader demonstrates operational, customer-focused business acumen to oversee the review processes and associated Recognition Operations projects, policies and procedures. With knowledge of the Patient-Centered Medical Home program (PCMH) and related products, this role oversees one of three operational teams responsible for the timely and accurate delivery of NCQA's Recognition and Prevalidation programs.

Adept at managing both people and complex processes, this leader ensures an effortless customer experience throughout the full Transformation and Annual Reporting evaluation processes and audit. The position inspires and empowers staff and uses process improvement skills to optimize relationships, workflows and outcomes.

Leveraging data and systems, the Assistant Director uses dashboards and reporting to ensure staff members have a balanced workload and that evaluations are delivered timely and consistently to our valued customers. A critical thinker and expert collaborator, this leader supports the organization's strategic plan by ensuring achievement of performance targets, planning and facilitating internal and external meetings, representing the department on projects and supporting, contributing to and implementing organizational initiatives.

Primary Responsibilities:

• Serve as part of the unit's management team to provide direction and management of end-to-end recognition processes.
• Ensure Recognition teams deliver efficiency, consistency, use of Salesforce and excellent customer service throughout all stages of recognition process for evaluations.
• Work with team to ensure timely intro calls with assigned practice sites, system troubleshooting, retention outreach, policy clarification and implementation of transforming review and annual reporting process
• Operational leadership and project management: Identify improvement projects to enhance efficiency and reduce product delivery risk. Work across various NCQA teams to identify and implement staffing and business processes to efficiently transition products from design to delivery stage.
• Work with Quality and Process Improvement team to proactively identify system improvements. Demonstrate in-depth understanding of the Quality Performance Assessment Support System (Q-PASS), Salesforce and Power BI in order to effectively manage the business and serve customers.
• Supervises a multi-disciplinary team of health care professionals to administer the Recognition and Prevalidation processes. Identify personnel needs to senior leadership, recruit, select, educate, provide constructive feedback to and mentor personnel.
• Work as part of unit's management team to oversee day-to-day Recognition process, including enrollment, audits, issues escalated and reports to ensure compliance with TAT goals for all Recognition tasks. Review and incorporate ROC comments, as needed, for denial recommendations.
• Ensure consistency of Recognition standards interpretation and process implementation by all professionals who are administering the Recognition process including internal and external evaluators, Recognition personnel and ROC members.
• Escalate inconsistencies proactively to policy team and work collaboratively to ensure interrater reliability.
• Work with ADs and Director to address evaluator conduct issues during virtual reviews and to track in Salesforce evaluator issues.
• Draft and revise internal policies and procedures to guide the recognition process. Provide competency-based training to all Recognition operations staff regarding policies and procedures on a regular basis to ensure understanding and adherence
• Continuously improve the recognition process by identifying overarching areas for improvement to senior leadership, developing and implementing improvement strategies, working with QPI team on priority projects, drafting and implementing policies and procedures and measuring results.

Requirements:

• Bachelor's degree
• 3-5 years operational and personnel management experience
• Knowledge of NCQA recognition process and/or other health services accreditation
• Successful track record of working across departments with multi-disciplinary professional teams
• Strong problem-solving skills, analytical capabilities, and collaboration skills
• Meeting management and facilitation skills
• Strong team leadership and people skills
• Ability to excel and remain agile in a fast-paced environment
• Analytical skills - critical thinking - data driven decisions
• Initiative - demonstrates ownership and accountability
• Effective written and oral communication
• Clearly and concisely conveys message
• Gives and receives constructive feedback
• Project implementation or product delivery skills
• Planning and organization skills
• Conflict resolution experience
• Team and change management skills
• Demonstrated proficiency utilizing dashboards and reporting for proactive workload management and throughput processes

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

NCQA is a drug free workplace. NCQA recruits, hires, trains and promotes individuals, and administers any and all personnel actions, without regard to race, color, religion, national origin, age, sex, pregnancy, citizenship, familial status, disability status, veteran status, genetic information, or other protected statuses under applicable state and federal laws.

NCQA will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c).