Senior Accreditation Professional-Remote US

Profile

Description

The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana.

Responsibilities

Location: Work at Home Anywhere

The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana.

Responsibilities include but are not limited to:


Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies that impact plan compliance with national accreditation standards.
Works closely with operational areas to prepare documentation and files for presentation to NCQA
Advises operational leaders and frontline associates in developing functional strategies for compliance with accreditation standards
Self-directed, exercises independent judgement and decision-making on complex issues regarding job duties and related tasks, and works under minimal supervision.
Uses independent judgement requiring analysis of variable factors and determining the best course of action.


Required Qualifications


Bachelor's Degree or BSN degree
5 or more years of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral Health, and/or Case Management
Exceptional analytical and critical thinking skills, including problem solving and proficiency in executing solutions
Exceptional attention to detail
Demonstrated excellent time management skills with proven ability to be flexible, adapt to changing environment, handle multiple tasks and deadlines and manage multiple priorities
Commitment to continuous process improvement
Exceptional verbal and written communication skills
Demonstrated successful relationship building
Experience working with cross-functional business areas


Work-At-Home Requirements


WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Preferred Qualifications


Registered Nurse or Behavioral Health professional
Advanced degree in a healthcare-related field
Knowledge of NCQA accreditation standards and processes for Health Plan Accreditation, Wellness & Health Promotion Accreditation, Multicultural Healthcare Distinction, and/or LTSS Distinction
Auditing experience


Additional Information

Location: Work at Home Nationwide with limited travel for trainings and meetings.

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from **** with instructions to add the information into the application at Humana's secure website.

Scheduled Weekly Hours

40

Company info

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