Credentialing Lead

Employment Type: Full-time Location Type: Remote Pay Range: $94,900 - $130,500

Position Overview

Become a part of our caring community and help us put health first. The Credentialing Lead leads and manages various projects within the Credentialing organization. This role addresses problems of diverse scope and complexity, ranging from moderate to substantial.

Where You Come In

The Credentialing Lead acts as the Subject Matter Expert for Credentialing processes and State Regulations. You will advise executives on developing functional strategies (often segment-specific) on matters of significance. This role exercises independent judgment and decision-making on complex issues regarding job duties and related tasks, working under minimal supervision. You will analyze variable factors and determine the best course of action.

What Humana Offers

Humana is a Fortune 100 Company that values associate engagement and your well-being. We offer excellent professional development and continued education. Use your skills to make an impact!

Benefits:

• Benefits starting day 1 of employment
• Competitive 401k match
• Generous Paid Time Off accrual
• Tuition Reimbursement
• Parent Leave

Required Qualifications – What it Takes to Succeed

• Minimum of 5 years of Credentialing leadership experience.
• Minimum of 2 years of project management leadership experience.
• Prior business consulting and/or operational leadership experience, preferably for an auditing function.
• Knowledgeable in regulations governing health care industries (CMS & NCQA).
• Comprehensive knowledge of all Microsoft Office applications, including Word, Project, and Visio.
• Strong written and verbal communication skills.
• Demonstrated relationship-building skills.

Preferred Qualifications

• Excellent communication and presentation skills, including the ability to communicate and present details to Senior level leadership.
• Ability to work collaboratively with project stakeholders, regional teams, and clinical leaders at all levels of the organization.
• Experience collaborating and building relationships with 3rd party vendors.

Work at Home Requirements

To ensure Home or Hybrid Home/Office associates can work effectively, the self-provided internet service must meet the following criteria:

• A minimum download speed of 25 Mbps and an upload speed of 10 Mbps is recommended.
• Wireless, wired cable, or DSL connection is suggested.
• Satellite, cellular, and microwave connections may be used only if approved by leadership.
• Associates who live and work from home in California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide telephone equipment appropriate to meet the business requirements for the position.
• Work must be performed from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

As part of our hiring process, we will be using HireVue, an interviewing technology, to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours: 40