Humana
Senior Quality Assurance Professional
Houston, TX · Senior · Full-time
Sponsorship not specified$86k-$119kDetected 1 day ago
ComplianceProject ManagementAuditingProcess ImprovementHIPAALeadershipCommunication
About the role
- This role serves as the subject matter expert for accreditation standards, credentialing quality processes, and continuous improvement efforts.
- Humana reserves the right to require associates to upgrade their internet service if necessary.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Responsibilities
- Lead NCQA Credentialing Accreditation preparation, submission, and maintenance activities.
- Conduct accreditation readiness assessments and implement corrective action plans.
- Develop, review, and maintain policies, procedures, and supporting documentation.
- Partner with the Quality Lead to track, analyze, and report quality metrics.
- Perform audits, quality reviews, and process improvement activities.
- Support regulatory audits and compliance initiatives as needed.
- Collaborate with operational and leadership teams to ensure ongoing compliance with accreditation and quality standards.
- The Senior Quality Assurance Professional partners closely with Credentialing, Quality, Compliance, and Operations leadership to ensure adherence to regulatory, accreditation, and organizational requirements.
- In addition to leading accreditation readiness activities, this position supports quality metric tracking, reporting, auditing, and improvement initiatives.
- The role may also provide operational support to the Compliance department during periods of increased regulatory activity or audit preparation.
Requirements
- In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs.
Nice to have
- Experience with NCQA standards and accreditation processes strongly preferred.
Compensation
- 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.
- $86,200 - $118,600 per year
- This job is eligible for a bonus incentive plan.
- This incentive opportunity is based upon company and/or individual performance.
Benefits
- This job is eligible for a bonus incentive plan.
- 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.
- Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company.
- 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.
Company info
- About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
- 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.
- About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company.
- Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large.
- Learn more about what we offer at Humana.com and at CenterWell.com.
- Become a part of our caring community
Equal opportunity
- 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.
This listing is sourced directly from Humana's careers page and normalized into a canonical job model.