Capital BlueCross
Sr. Quality And Accreditation (Finance)
Job Requirements
Leadership:
Skills:
Demonstrated excellent verbal communication.
Excellent problem solving and critical thinking skills.
Detail oriented and strong project management skills.
Strong computer skills, must be excellent with Microsoft applications; Excel, Word, Visio, and PowerPoint.
Excellent communication in written form in order to prepare detailed reports that accurately convey the issue/problem/situation and recommended action in a clear and concise manner.
Knowledge:
Strong capabilities to research and answer questions
Knowledge of accreditation and/or regulatory standards such as; PA Department of Health, Department of Insurance, NCQA, CMS and HCR
Knowledge of Capital's product offerings
Knowledge of current and emerging industry trends in health care plans and quality management practices
Experience:
Minimum of 5 years of health plan/managed care experience
Preferred knowledge of NCQA standards
Preferred experience with project management techniques and process mapping/engineering
Education, certifications, and Licenses:
Bachelor's degree (or equivalent experience) in a health related field and /or an active health care licensure
Must maintain a valid Pennsylvania driver's license.
Capital BlueCross is an independent licensee of the BlueCross BlueShield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.