Talent.com
Accreditation Professional
Accreditation ProfessionalUSA Jobs • Charleston, WV, US
No longer accepting applications
Accreditation Professional

Accreditation Professional

USA Jobs • Charleston, WV, US
2 days ago
Job type
  • Full-time
Job description

Accreditation Professional 2

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

The Accreditation Professional 2 supports the team by managing a variety of tasks related to the administration of the NCQA accreditation survey process. The Accreditation Professional 2 work assignments are varied and flexibility is required in collaborating with teammates to respond to rapidly changing business needs.

Detail oriented and able to juggle multi-step processes for a multitude of simultaneous / overlapping accreditation surveys.

Survey administration tasks include preparing and loading documents into NCQA's online submission tool, coordinating document reviews with multiple stakeholders, and scheduling key meetings and audits.

Able to organize team documentation and archive.

Support management of large-scale NCQA governance committee by building newsletters and taking meeting minutes.

Assist in document review of member handbooks and provider manuals to ensure NCQA compliance.

Support leadership in developing AI capabilities for accreditation work.

Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.

Follows established guidelines / procedures.

Use your skills to make an impact.

Required Qualifications

Bachelor's degree

1+ year of experience in process improvement, data analytics, Compliance, Risk Management, and / or program implementation / design

Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, PowerPoint, and Teams

Demonstrated excellent time management skills with proven ability to be flexible, adapt to changing environment, handle multiple tasks and deadlines and manage multiple priorities

Exceptional verbal and written communication skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Desire to develop in-depth knowledge of the NCQA accreditation process and standards

Preferred Qualifications

Previous experience working in a managed care field

Accreditation experience or experience in operational areas subject to accreditation requirements (such as utilization management, case management, credentialing, network operations, quality)

Previous experience working with AI

SharePoint and Smartsheet experience

Schedule : This department follows a 9 / 80 schedule. Employees work nine hours per day for nine days and have every other Friday off. Associates may opt for a standard schedule if preferred : Monday through Friday, 8 : 00 AM - 5 : 00 PM Eastern and able to accommodate schedules and meetings in both Central and Eastern time zones.

Work Location : United States

Work Style : Remote

Travel Requirements : Light travel (once a year)

Work-at-Home (WAH) Internet Statement

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 suggested.

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.

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.

Pre-Screening - If you are selected to move forward after the application prescreen, you will receive an email invitation to complete a pre-recorded video questionnaire. In this step, you will respond to a set of interview questions using your mobile device. The video interview is brief and typically takes approximately 10-15 minutes to complete.

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

$65,000 - $88,600 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline : 11-25-2025

About Us

Humana Inc. (NYSE : HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.

Create a job alert for this search

Accreditation Professional • Charleston, WV, US

Related jobs
Licensed Professional Counselor

Licensed Professional Counselor

Headway • Charleston, WV, United States
Full-time
Licensed Professional Counselor at Headway summary : .A Licensed Professional Counselor (LPC) provides mental health counseling services, either starting or expanding a private practice.They assist c...Show more
Last updated: 7 hours ago • Promoted • New!
Licensed Professional Counselor (Virtual)

Licensed Professional Counselor (Virtual)

Headway • Charleston, WV, United States
Full-time
Licensed Professional Counselor (Virtual) at Headway summary : .A Licensed Professional Counselor (LPC) provides mental health therapy services, often running or expanding a private practice.Using pl...Show more
Last updated: 7 hours ago • Promoted • New!
Remote Content QA Reviewer

Remote Content QA Reviewer

Outlier • Charleston, WV, United States
Remote
Full-time
Earn up to $15 / hour + performance bonuses.Outlier, a platform owned and operated by Scale AI, is looking for.If you're passionate about improving models and excited by the future of AI, this is you...Show more
Last updated: 7 days ago • Promoted
Direct Support Professional

Direct Support Professional

ResCare Community Living • Logan, WV, United States
Full-time
ResCare Community Living - Direct Support Professional.Thank you for reviewing our Direct Support Professional position at ResCare Community Living. As a DSP, you play a crucial role in helping us p...Show more
Last updated: 30+ days ago • Promoted
Reconciliation Senior Specialist

Reconciliation Senior Specialist

Cardinal Health • Charleston, WV, United States
Full-time
What Product or Services Marketing contributes to Cardinal Health.Marketing is responsible for assessing customer needs, market conditions and competition to inform business strategy.Marketing impl...Show more
Last updated: 1 day ago • Promoted
Director, Contract Compliance MHT

Director, Contract Compliance MHT

The Health Plan of West Virginia Inc • Charleston, WV, US
Full-time
The MHT Director, Contract Compliance and Administration, is responsible for the overall delivery of the WV Medicaid / WVCHIP Mountain Health Trust managed care contract with the WV Bureau for Medica...Show more
Last updated: 5 days ago • Promoted
Director of Credit Policy and Underwriting Operations - Granite

Director of Credit Policy and Underwriting Operations - Granite

Altisource • United, WV, US
Full-time
Director of Credit Policy and Underwriting Operations - Granite.Join a dynamic organization at the forefront of construction and mortgage lending innovation. We deliver exceptional client outcomes t...Show more
Last updated: 23 hours ago • Promoted
Initial Licensing Specialist

Initial Licensing Specialist

Necco, LLC • Elkview, WV, US
Full-time
Necco has an opportunity for a career as an Initial Licensing Specialist.This position will add value to the company by lead, manage and direct Recruitment & Retention policies, procedures, and...Show more
Last updated: 23 days ago • Promoted
Pharmacy Contracting Professional 2

Pharmacy Contracting Professional 2

Humana • Charleston, WV, United States
Full-time
Become a part of our caring community and help us put health first.The Pharmacy Contracting Professional 2 ensures contract compliance and performs analysis regarding pharmacy claims.Understands de...Show more
Last updated: 14 hours ago • Promoted • New!
Client Intake Specialist

Client Intake Specialist

Frost Brown Todd LLP • Charleston, WV, US
Full-time
This individual will be responsible for reviewing electronic new business intake forms submitted in connection with new business for existing and new firm clients, conducting searches of the Firm&#...Show more
Last updated: 30+ days ago • Promoted
Senior Director, Public Sector Compliance

Senior Director, Public Sector Compliance

West Virginia Staffing • Charleston, WV, US
Full-time
Senior Director Of Public Sector Compliance Operations.Manages the ongoing preparation, testing, and monitoring of compliance with information security standards and government regulations and regu...Show more
Last updated: 2 days ago • Promoted
Senior Contracts Specialist

Senior Contracts Specialist

AmerisourceBergen Corporation (Cencora) • Charleston, WV, United States
Full-time
Our team members are at the heart of everything we do.At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on ...Show more
Last updated: 30+ days ago • Promoted
Chaplain

Chaplain

US Navy • Charleston, West Virginia, United States
Part-time
As a Religious Program Specialist (RP), you're more than a facilitator of religious services.To our Sailors, you are the listening ear, helping hand and friendly face they may need to get through t...Show more
Last updated: 14 days ago • Promoted
Senior Claims Specialist

Senior Claims Specialist

CorVel Enterprise Claims, Inc. • Charleston, WV, US
Full-time
The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to dete...Show more
Last updated: 30+ days ago • Promoted
Experienced Tax Professional

Experienced Tax Professional

H&R Block • Charleston, WV, US
Full-time
At H&R Block, we believe in the power of people helping people.Our defining Purpose is to provide help and inspire confidence in our clients, associates, and communities everywhere.We also believe ...Show more
Last updated: 13 days ago • Promoted
Sales Associate

Sales Associate

West Virginia Staffing • Charleston, WV, US
Full-time
United Bank is an Equal Opportunity employer.Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, ...Show more
Last updated: 18 days ago • Promoted
Strategic Account Activation Lead

Strategic Account Activation Lead

West Virginia Staffing • Charleston, WV, US
Full-time
Strategic Account Activation Lead.The Strategic Account Activation Lead serves as a professional sales leader in building and maintaining a profitable and proactive relationship with assigned strat...Show more
Last updated: 9 days ago • Promoted
Athletic Trainer

Athletic Trainer

H2 Health • Hurricane, WV, US
Full-time
Athletic Trainer | Full-Time | 3910 Teays Valley Rd, Hurricane, WV 25526.At Teays Physical Therapy, we prioritize the health and performance of our athletes. As an Athletic Trainer (ATC) in our outp...Show more
Last updated: 30+ days ago • Promoted