Senior Quality Improvement Professional

Profile

Job Information
Humana
Senior Quality Improvement Professional
in
Fort Wayne
Indiana
Description
The Senior Quality Improvement Professional implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Senior Quality Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
The Senior Quality Improvement Professional monitors quality investigations and compliance processes. Manages quality management system, department SharePoint, and department reporting. Audits processes as needed for compliance. Completes and submits reports to CMS and state regulators as required for clinical studies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Required Qualifications
Bachelor's degree or 5 years related Quality Improvement experience
Prior experience in a fast-paced health insurance or health care setting
Understanding of healthcare quality measures HEDIS, STARS, CMS, etc.
Comprehensive knowledge of Microsoft Office Suite (i.e., excel, word, etc.)
Workstyle: Remote Work at Home
Primary Location:
Ohio
Alternate locations:
Reside in a city/county that borders Ohio state line within one of the following states
Indiana, Kentucky, Michigan, Pennsylvania, West Virginia,
Candidates outside this area may be considered with a COMPACT Ohio License
Schedule/Hours:
Monday - Friday 40-hour work week schedule 7:00 AM-6:00 PM Eastern
Occasional over-time or weekends as business needs require
Travel: 20%
Work at Home Requirements
Must have a separate room with a locked door that can be used as a home office to ensure you absolute and continuous privacy while you work
Must have accessibility to hardwired high speed internet with minimum speeds of 25Mx10M for a home office (Wireless and Satellite are prohibited)
Humana Driver's License, Insurance, Transportation Requirement
This role is part of Humana's Driver safety program and therefore requires an individual to have:
a valid state driver's license,
reliable transportation,
and proof of personal vehicle liability insurance with at least 100/300/100 limits
Preferred Qualifications
Knowledge of QI methodologies (i.e. IHI model of improvement) and familiarity with QI Tools (i.e. FMEA, KDD, workflows/diagrams, root cause analysis)
CPHQ
Lean Six Sigma
Proven analytical skills
Excellent communication skills, both oral and written
Knowledge of Humana's internal policies, procedures, and systems
Experience in member/provider education and communications
Additional Information
Interview Format
As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
You will be able to respond to the recruiters preferred response method via text, video or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Covid Compliance Policy
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.
Scheduled Weekly Hours
40
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 ****

Company info

Sign Up Now - QAQCCrossing.com