Accreditation Specialist Lead (Remote)
ExpediaSalary not specified
Full Time
Senior (5 to 8 years), Expert & Leadership (9+ years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries
Requirements
- Bachelor's degree
- 1+ year of experience in process improvement, data analytics, Compliance, Risk Management, and/or program implementation/design
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, PowerPoint, and Teams
- Demonstrated excellent time management skills with proven ability to be flexible, adapt to changing environment, handle multiple tasks and deadlines and manage multiple priorities
- Exceptional verbal and written communication skills
- Passionate about contributing to an organization focused on continuously improving consumer experiences
- Desire to develop in-depth knowledge of the NCQA accreditation process and standards
- Preferred Qualifications
- Previous experience working in a managed care field
- Accreditation experience or experience in operational areas subject to accreditation requirements (such as utilization management, case management, credentialing, network operations, quality)
- Previous experience working with AI
- SharePoint and Smartsheet experience
Responsibilities
- Manage a variety of tasks related to the administration of the NCQA accreditation survey process
- Prepare and load documents into NCQA’s online submission tool
- Coordinate document reviews with multiple stakeholders
- Schedule key meetings and audits
- Organize team documentation and archive
- Support management of large-scale NCQA governance committee by building newsletters and taking meeting minutes
- Assist in document review of member handbooks and provider manuals to ensure NCQA compliance
- Support leadership in developing AI capabilities for accreditation work
- Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas
- Make decisions regarding own work methods, occasionally in ambiguous situations, with minimal direction
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What is the work schedule and location policy for this role?
The department follows a 9/80 schedule with nine-hour days for nine days and every other Friday off, or a standard Monday-Friday 8:00 AM–5:00 PM Eastern schedule; the role is remote in the United States with light travel once a year.
What are the required qualifications for the Accreditation Professional role?
A Bachelor's degree, 1+ year of experience in process improvement, data analytics, Compliance, Risk Management, and/or program implementation/design, comprehensive knowledge of Microsoft Office applications, excellent time management skills, and exceptional communication skills are required.
What is the salary or compensation for this position?
This information is not specified in the job description.
What does the team environment look like at Humana for this role?
The role involves collaborating with teammates in a caring community focused on putting health first, with flexibility required to respond to rapidly changing business needs and juggling multi-step processes for multiple accreditation surveys.
What makes a strong candidate for this Accreditation Professional position?
Strong candidates have previous experience in managed care, accreditation, or operational areas like utilization management, plus experience with AI, SharePoint, and Smartsheet, along with passion for improving consumer experiences.
Humana
Health insurance provider for seniors and military
About Humana
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.
Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees