Group Health QA Supervisor - RN
Blank StreetSalary not specified
- Full Time
- Junior (1 to 2 years), Junior (1 to 2 years)
Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Health InsuranceIndustries
Requirements
Candidates should possess a Bachelor’s degree and three years of experience in NCQA Health Plan Accreditation with a focus on Credentialing Accreditation, along with prior experience participating in NCQA virtual or onsite surveys. They must demonstrate a commitment to continuous process improvement, exceptional analytical and critical thinking skills, including problem-solving, and proficiency in executing solutions, alongside exceptional attention to detail and time management skills. Superior verbal and written communication skills, and demonstrated successful relationship building experience are also required.
Responsibilities
The Senior Accreditation Professional will serve as a subject matter expert on NCQA Health Plan Accreditation Credentialing (CR) requirements, advising stakeholders on compliance, working closely with operational areas to prepare documentation for submission to NCQA, and advising operational leaders and frontline associates in developing functional strategies for compliance with accreditation standards. They will exercise independent judgement and decision-making on complex issues, use their skills to make an impact, and contribute to ongoing process improvement.
Skills
NCQA Health Plan Accreditation
Credentialing
Compliance
Documentation Preparation
Operational Strategy
Analytical Skills
Critical Thinking
Problem Solving
Time Management
Communication
Relationship Building
Cross-functional Collaboration
Process Improvement
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.
Key Metrics
Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees