Quality Improvement Professional

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

The Quality Improvement Professional implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Quality Improvement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. This position will partner closely with the Sr. Quality Improvement Professional(s) on projects and deliverables.

The Quality Improvement Professional understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. The position makes decisions regarding work methods and receives guidance where needed. Assist the senior professionals with data gathering required for strategy development and care gap closure. Follows established guidelines/procedures.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's degree or equivalent experience
• Prior quality improvement experience in health insurance or health care setting
• Understanding of healthcare quality standards
• Understanding of healthcare quality measures (i.e., HEDIS, CAHPS, STARS, CMS etc.)
• Excellent communication skills, both oral and written
• Strong relationship building skills
• Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint
• Must reside in state of Oklahoma

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)
• Proven analytical skills
• Lean/Six Sigma certification
• CPHQ certification
• Knowledge of policies, procedures, and systems used in quality improvement
• Prior experience in Medicaid membership
• Experience in member/provider education and communication.

Additional Information

This position is open to work remote in Oklahoma.

Work at Home Criteria  

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 recommended; 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. Modern Hire 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.  

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.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.