Accreditation Representative

Job Description

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

UNC Health Nash, an affiliated member of the UNC Health system, invites passionate healthcare professionals to join our esteemed team. Governed locally, we proudly serve a diverse patient base, spanning Nash, Edgecombe, Halifax, Wilson Counties, and beyond. With a steadfast commitment to elevating community health through exceptional care, we prioritize excellence, compassion, and innovation, ensuring every individual receives the highest standard of support. Joining our team means becoming an integral part of our dedication to wellness, where we constantly strive to redefine excellence in healthcare through state-of-the-art facilities and pioneering programs. Join us in this transformative journey, where your contributions will make a lasting impact on our community's health and wellbeing.

Summary:

The Accreditation Representative is responsible for assuring compliance with the American College of Surgeons Commission on Cancer (ACS CoC) Standards. This role is critical to maintaining accreditation readiness and supporting oncology program excellence. Key responsibilities include managing Tumor Board Conferences, which occur on an alternating schedule of two conferences one week and three conferences the following week, managing Cancer Committee, and overseeing the processing and follow-up of referrals to other specialties/imaging as requested by oncologists. The position requires strong organizational skills, attention to detail, and the ability to collaborate effectively across departments to support high-quality cancer care delivery.

Responsibilities:

1. Accreditation Compliance: Ensures all ACS CoC Standards are met for accreditation. Leads survey preparation at the facility, including completion of the Program Application Record (PAR), Survey Application Record (SAR), and surveyor documentation.

2. Cancer Committee Support: Coordinates and facilitates all Cancer Committee Meetings to ensure compliance with CoC accreditation standards. Responsibilities include scheduling meetings, preparing agendas, ensuring attendance of required multidisciplinary members, recording minutes, and maintaining documentation. Assists with the completion of the Cancer Program’s Annual Report.

3. Tumor Board Coordination & Evaluation: Serves as the Cancer Conference/Tumor Board Coordinator, facilitating all conferences by managing scheduling, agendas, collection of patient documents and imaging, and documentation of case outcomes. Monitors, evaluates, and analyzes all Tumor Board activities, including attendance, case presentations, and ensuring staging and prognostic indicators are thoroughly discussed.

4. Education & Training: Attends state and national educational activities as approved by the director. Participates in required continuing education programs to maintain knowledge of accreditation standards and oncology program requirements.

5. Referral Management: Monitors and processes internal and external referrals requested by oncologists, ensuring timely coordination with other specialties.

6. Additional Duties: This job profile is intended to provide a representation of responsibilities required. Employees may be requested to perform job-related tasks other than those specifically presented in this profile.

Other information:

Education Requirements:

• High School Diploma required; BA/BS preferred, in healthcare administration, public health, or related field

License/Certification Requirements:

Experience Requirements:

• 2–3 years of experience in a healthcare setting, preferably in compliance, oncology, or quality management

• Strong organizational and communication skills

• Ability to manage multiple priorities and deadlines

• Familiarity with healthcare regulations and accreditation processes

• Proficiency in Microsoft Office Suite and data management tools

Preferred Skills

• Experience coordinating medical conferences or committees

• Knowledge of ACS CoC accreditation standards

• Ability to work independently and collaboratively in a fast-paced environment

• Strong attention to detail and problem-solving skills

Job Details

Legal Employer: Nash Hospitals

Entity: Nash UNC Health Care

Organization Unit: NGH Nash Cancer Center

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: NASH HC

Exempt From Overtime: Exempt: No

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.