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Accreditation Professional
Accreditation ProfessionalWest Virginia Staffing • Charleston, WV, US
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Accreditation Professional

Accreditation Professional

West Virginia Staffing • 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 1015 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 : The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $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. See our https : / / www.humana.com / legal / accessibility-resources?source=Humana_Website.

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    Accreditation Professional • Charleston, WV, US

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