Become a part of our caring community and help us put health first
 

We are seeking a Senior Accreditation Professional who will work 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.

Role Responsibilities:

• Serves as subject matter expert on NCQA Health Plan Accreditation Member Experience (ME) and Medicaid Module (MED) requirements, advising stakeholders on compliance.
• 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.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s Degree or BSN degree.
• 3+ years of experience in NCQA Health Plan Accreditation and/or Medicaid Module.
• 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.

Preferred Qualifications

• Managed care, Medicaid health plan experience.
• Advanced degree in a healthcare-related field.

Work at Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. ​

Additional information

• Workstyle: Remote, US
• Workdays/Hours: Standard work hours are Monday to Friday, 8:00 AM to 5:00 PM EST or CST, regardless of your local time zone; flexible arrangements may be discussed
• Travel: Less than 5% travel - typically 1-3 times annually, possibly outside of your state of residence, for team engagement meetings, onsite audits, and trainings.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue 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.  If selected to move forward with an interview, expect an email link to be sent to you to complete the video screening.

Social Security Task

Alert: Humana values personal identity protection.  Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file.  When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.  

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

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time