Senior Accreditation Professional

Profile

Job Information

Humana

Senior Accreditation Professional

in

Riverton

Wyoming

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

Registered Nurse or Behavioral Health professional

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

Bachelor's Degree or BSN degree

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

Company info

Humana Inc.
Website : http://www.humana.com