Supervisor Quality Assurance Managed Care BILINGUAL English/Spanish Hybrid - San Juan PR

Profile

Job Information

Humana

Supervisor Quality Assurance (Managed Care, BILINGUAL English/Spanish) Hybrid - San Juan, PR

in

San Juan

Puerto Rico

Description

The Supervisor, Quality Assurance develops and implements programs to establish and maintain quality standards of existing products and services, as well as developing programs to focus employees on the quality of care given to patients. The Supervisor, Quality Assurance works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach.

Responsibilities

The Supervisor, Quality Assurance develops policies, procedures and methods to check operational quality and improve same. Trains and/or coaches staff and management in areas such as quality improvement, process management and reliability science. Maintains communications with administration, medical staff and department heads regarding quality assurance activities. Decisions are typically are related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.

Required Qualifications

Requires Bachelor's Degree

Previous supervisory experience

Previous experience working in a Managed Care field

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

Proficiency in analyzing and interpreting data trends

Proven successful experience in completing efficient health-related research, with associated analysis and conclusions as well as develops policies, procedures and methods to check operational quality.

Experience in training and/or coaching staff and management in areas such as quality improvement, process management and reliability science.

Ability to make decisions on moderately complex to complex issues regarding technical approach for project components.

Strong organizational and communication skills (written and oral).

Home requirements

: Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Bilingual English/Spanish. Candidate selected will NOT be communicating in English with members.

COVID VACCINATION

: For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. 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, including booster or commit to testing protocols OR  

Provide proof of applicable exemption including any required supporting documentation ​​

Medical, religious, state and remote-only work exemptions are available.

Preferred Qualifications

Master in Business Administration or

Bachelor degree in Science of Nurse

Additional information

Schedule:

Monday to Friday from 8 am to 5 pm

Training: On the Job - Remotely

Work Location (Address):

This position will required to Work from Home and Office in a hybrid mode, upon business needs. The office location is at 383 Ave F D Roosevelt San Juan, PR 00918.

% Travel:

No travel

# of Direct Reports:

6

Scheduled Weekly Hours

40

Company info

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