Position SummaryThe Accreditation and Clinical Standards Coordinator serves as the primary project manager for the organization's accreditation lifecycle and a key strategic partner to the Vice President of Clinical Compliance. This role is the key strategic partner focused on Accreditation and Corrective Action. This role is responsible for the systematic gathering of evidence for accreditation standards and architecting solutions for any compliance gaps. Additionally, they provide critical support during Payor and State audits, assisting in the development and long-term maintenance of Corrective Action Plans (CAPs) to ensure sustained organizational excellence.
Duties and Responsibilities- Serve as the central point of contact for gathering, storing, and cataloging all clinical review materials and evidence required for accreditation submission.
- Identify standards not currently met and collaborate with leadership to architect and implement new clinical quality initiatives and processes to bridge those gaps.
- Act as a primary support to the Vice President of Clinical Compliance during external Payor and State audits, ensuring all requested documentation is provided and clinical standards are defended.
- Lead the drafting of Corrective Action Plans (CAPs) in response to audit findings and monitor ongoing adherence to ensure the organization remains in good standing.
- Incorporate accreditation standards into Centria's clinical quality review rubrics and ensure all documentation adheres to these enhanced quality standards.
- Work across multiple internal systems and departments to ensure clinical reviews are comprehensive and all stakeholders are included in the accreditation roadmap.
- Incorporate the insights on payor policy updates, AMA codes, and OIG requirements directly into their accreditation readiness work to ensure proactivity and timely implementation of compliance changes.
- Support policy review and revision as directed and approved by the Vice President of Clinical Compliance to ensure alignment with accreditation standards.
- Compliance with Centria's Code of Conduct, policies and procedures, and Federal and State laws.
- Responsibility to report violations of Company policies or the Code of Conduct.
Rate:
$95,000 - $110,000 plus bonus
QualificationsEducation- Master's degree required
- Doctorate preferred
Certification- BCBA or BCaBA certification (preferred)
- Bachelor's degree required
Work Experience- Proven track record navigating Medicaid, OIG, and private payor clinical audits.
- Deep mastery of the BACB Ethics Code for Behavior Analysts and HIPAA privacy regulations.
- Proven track record in a highly detail-oriented environment with a focus on data and analysis.
- Experience in clinical review, payor clinical review responses, or regulatory analysis.
Equipment and Technology Requirements- Working knowledge of laptop/desktop PC
- Proficiency in Microsoft Suite (Word, Excel)
- Proficiency in G Suite (Gmail, Drive, Docs, Sheets, Google Meet)
Other Competency Requirements- Ability to follow written instructions
- Ability to use computers and computer/software programs
- Ability to communicate expressively and receptively
Knowledge and Skills- Proven ability to design, implement, and manage robust operational processes that support organizational growth while maintaining high performance.
- Strategic mindset focused on identifying efficiencies and driving continuous improvement across a national, high-volume provider network.
- Advanced skill in detecting systemic operational and compliance risks within complex delivery models and implementing proactive safeguards.
- Ability to bridge the gap between rigorous regulatory documentation requirements and a child-led, compassionate care model.
- Proficiency in leveraging compliance frameworks not just as a "check-the-box" exercise, but as a tool to solve complex business problems.
- Expert knowledge of accreditation coordination processes and the ability to lead initiatives that sustain industry-leading quality standards.
- Demonstrated success in leading and mobilizing Subject Matter Experts (SMEs) to address and resolve multifaceted organizational challenges.
- Ability to align diverse stakeholders around shared quality benchmarks and operational goals.
- Capacity to view local issues through a national lens, ensuring consistency in care and compliance across all regions.
- Proven ability to organize, prioritize, and handle multiple complex tasks under strict deadlines.
Working Conditions- Centria's office hours are Monday through Friday from 8:30 AM - 6:00 PM.
- Additional time or occasional shift in schedule may be required to complete the above work or meet company objectives.
- Periodic national travel to regional centers and the Resource Center for site audits and leadership summits will be required.
Physical DemandsWhile performing the duties of this job, physical requirements such as bending, reaching, lifting, pushing, or pulling up to 30 pounds may be required. This role will require sitting most of the day as well as walking and standing periodically. This role may require close visual acuity on computer screens or monitors and the ability to analyze data and figures on a screen.
