NCQA Quality Accreditation Lead - Denver Health Medical Plan (* Weekly Hybrid Schedule Requirement *)

We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.

Our Values

Respect | Belonging | Accountability | Transparency

Department

Job Summary

This role is responsible for coordination and maintenance of Denver Health Medical Plan's compliance to meet NCQA (National Committee for Quality Assurance) standards and other regulatory requirements. This role involves overseeing collection and submission of deliverables related to organization quality improvement initiatives, ensuring adherence to regulatory guidelines, and coordinating internal audits. This role is a key team member to support continuous process improvement efforts across all plan departments to successfully achieve and maintain NCQA accreditation status.

Essential Functions:

• Support NCQA accreditation activities, including survey preparation, documentation collection, submission, and follow-up (25%)
• Partner with the Compliance team to help monitor adherence to state Medicaid regulatory and contractual requirements (15%)
• Assist in reviewing and summarizing accreditation standards and communicating updates to impacted departments (5%)
• Coordinate with departmental contacts to support timely completion of accreditation deliverables and ensure engagement (15%)
• Serve as a point of contact for internal stakeholders and assist in coordinating communications with NCQA surveyors (5%)
• Track project time lines and milestones; support development and maintenance of accreditation work plans (15%)
• Facilitate coordination across cross-functional teams (Quality, Compliance, Operations, IT) (5%)
• Assist in conducting mock surveys and internal audits to support readiness efforts (5%)
• Identify potential compliance gaps and support implementation of corrective action plans (5%)
• Support quality initiatives, including HEDIS and CMS Core Measure performance improvement activities (5%)

Education:

• Bachelor's degree healthcare administration, public health, nursing, or related field required

Work Experience:

• 4-6 years healthcare quality, compliance, or accreditation required and
• 1-3 years supporting NCQA accreditation activities required and
• 1-3 years supporting Medicaid regulatory requirements required

Licenses:
Knowledge, Skills and Abilities:

• Working knowledge of health plan operations and regulatory standards
• Exposure to CMS and Colorado HCPF regulations
• Familiarity with HEDIS, Medicare Stars, CAHPS, or similar quality programs
• Experience supporting projects or process improvement initiatives
• Strong organizational and coordination skills
• Solid analytical and problem-solving abilities
• Clear and effective communication skills
• Attention to detail and accuracy in documentation
• Ability to manage multiple tasks and meet deadlines

Shift

Work Type

Salary

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future - with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development - while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you're joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

• Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays

• 100% paid parental leave up to 6 weeks

• Immediate eligibility for retirement plans with employer contribution up to 9.5%

• Generous medical, dental, vision plans in addition to employer paid disability and life insurance.

• Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center

• Free RTD EcoPass (public transportation)

• Childcare discount programs & exclusive perks on large brands, travel, and more

• Tuition reimbursement & assistance

• Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways

• Professional clinical advancement program & shared governance

• Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program

• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.

As Colorado's primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.