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Senior Accreditation Professional

at Humana in Rogers, Arkansas, United States

Job Description

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.

Role Requirements

+ 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

Role Desirables

+ 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.

We will require?full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a?healthcare?company committed to putting health and safety first for our members, patients, associates and the communities we serve.

If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law.

Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Scheduled Weekly Hours

40

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Job Posting: JC192740312

Posted On: Sep 18, 2021

Updated On: Oct 14, 2021