Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

JOB SUMMARY
The Accreditation Manager is responsible for leading and overseeing all organizational efforts related to achieving and maintaining URAC accreditation and certification standards. This role ensures full compliance with URAC requirements, coordinates cross-departmental activities, and provides strategic direction to quality improvement initiatives aligned with URAC programs. They are responsible for annual and as-needed review of accreditation-related policies and procedures. The role requires strong knowledge of managed care operations and accreditation standards, particularly in Texas' MCO landscape. The role also supports Sr. Manager of NCQA with accreditation efforts when they align with URAC standards.

JOB SPECIFICATIONS AND CORE COMPETENCIES

• URAC Accreditation Planning & Management
• Lead planning, coordination, and execution of URAC accreditation and reaccreditation efforts., as well as support the organization with NCQA accreditation on standards that align.
• Monitor changes in URAC standards and ensure organizational policies and practices remain compliant. Develop educational materials and conduct training sessions for internal
• departments regarding URAC requirements.
• Provide training and guidance to department leads and staff on URAC standards.
• Cultivate a culture of quality and accountability.
  
  Accreditation Compliance & Documentation
  
• Serve as the primary liaison with URAC and internal stakeholders.
• Lead cross-functional teams to compile, review, and submit documentation for accreditation.
• Conduct internal audits, gap analyses, and readiness assessments to ensure timely compliance.
• Guide departments in developing documentation to meet standards. (plans, evaluations, policies, and procedures. Conducts quality checks of all documents prior to submission.
• Review and revise policies and procedures to ensure alignment with URAC standards.
• Develop and track performance metrics aligned with compliance and accreditation goals.
  
  Stakeholder Collaboration & Reporting
• Lead partnership with internal departments such as Quality Improvement, Compliance, UM, CM, and Customer Service to align procedures with accreditation standards.
• Prepare reports, dashboards, and presentations for senior leadership and external regulatory agencies.
• Actively contributes to achievement of departmental goals, as identified in Departments annual business plan, including specific departmental process improvement plans and other duties as assigned.
• Reports to Position Title: Director, Quality Improvement
  
  
  QUALIFICATIONS:
• Education/Specialized Training/Licensure: Bachelors degree in business or health care field required.
  Or 10 years of progressive responsible management experience in health care environment in lieu of degree required.
• Masters degree in a health care related field or business is strongly preferred.
• Work Experience (Years and Area): 5 years progressively responsible management experience in a health care environment required.
• Minimum 3 years' experience if Masters degree is held
• Management Experience (Years and Area): At least 3 years of experience with URAC accreditation processes and standards required.
• Minimum 3 years of experience in a leadership role including managing and overseeing quality staff, clinical staff, or manage quality initiatives preferred.
  
  Software Proficiencies: Microsoft Office (Word, Excel, PowerPoint, Outlook)
  Other: Strong project management and organizational skills.
  
  Excellent written and verbal communication skills.
  Ability to lead cross-functional teams and manage multiple projects simultaneously.
  
  Job Family/Job Title Competencies
  Analytical Thinking
  Critical Thinking
  Leadership
  Leadership