Home Health Manager, Quality Assurance at Humana

Miramar, Florida, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Bachelor's Degree
6 or more years of quality improvement, process management and reliability science
2 or more years management/leadership experience as a supervisor, manager or director
Advanced experience leading special projects and producing metrics, measurements and trend reports
2 or more years experience working in a managed care field
Demonstrated ability to run large scale, highly visible programs with responsibility for multiple project teams
Proficiency in analyzing and interpreting data trends
Comprehensive knowledge of all Microsoft Office applications, including Outlook, Word, Excel and PowerPoint
Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Responsibilities

Develops and implements programs to establish and maintain quality standards of existing products and services
Develops programs to focus employees on the quality of care given to patients
Works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems
Receives assignments in the form of objectives and determines approach, resources, schedules and goals
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
Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area
Requires cross departmental collaboration, and conducts briefings and area meetings
Maintains frequent contact with other managers across the department

Skills

Quality Improvement

Process Management

Reliability Science

Data Analysis

Metrics Reporting

Trend Analysis

Project Management

Microsoft Excel

Microsoft PowerPoint

Microsoft Word

Microsoft Outlook

Leadership

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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