Senior Quality Improvement Professional

Position Overview

Become a part of our caring community and help us put health first. The Senior Quality Improvement Professional supports Quality Improvement functions for the Ohio Medicaid plan. This role involves assignments and projects that address moderately complex to complex issues, requiring in-depth evaluation of variable factors. The Senior Quality Improvement Professional participates in and leads projects associated with Quality Withhold, vendor management, internal and external audits, and the Quality Improvement Committee. The role demands the ability to work independently with minimal direction and manage multiple projects concurrently. This is a highly visible position requiring collaboration across a matrixed organization.

Use your skills to make an impact

Requirements

• Must reside in EST or CST time zone.
• Bachelor's degree or 5 years of related Quality Improvement experience.
• Prior experience in a fast-paced health insurance or health care setting.
• Understanding of healthcare quality measures (e.g., HEDIS, STARS, CMS).
• Comprehensive knowledge of Microsoft Office Suite (e.g., Excel, Word).
• Ability to present information across different levels of the organization.
• Ability to successfully work individually and collaboratively, internally and externally.

Preferred Qualifications

• Reside in the state of Ohio.
• Knowledge of QI methodologies (e.g., IHI model of improvement) and familiarity with QI Tools (e.g., FMEA, KDD, workflows/diagrams, root cause analysis).
• CPHQ certification.
• Lean Six Sigma certification.
• 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.

Workstyle & Schedule

• Location Type: Remote Work at Home
• Employment Type: Full-time
• Schedule/Hours: Monday - Friday, 40-hour work week. Schedule typically between 7:00 AM - 6:00 PM Eastern.
• Overtime: Occasional overtime or weekend work may be required as business needs dictate.
• Travel: 10%

Additional Information

• Interview Format: This role utilizes HireVue, an interviewing technology, for initial assessments.
• Internet Requirements: For remote work, a minimum download speed of 25 Mbps and an upload speed of 10 Mbps is required. Wired cable or DSL connection is suggested. Satellite, cellular, and microwave connections may be used only with leadership approval.
• Internet Stipend: Employees residing in California, Illinois, Montana, or South Dakota will receive a bi-weekly payment for internet expenses.
• Equipment: Humana will provide appropriate telephone equipment.
• Work Environment: A dedicated, interruption-free workspace is required to protect member PHI/HIPAA information.
• Occasional Travel: While this is a remote position, occasional travel to Humana offices for training or meetings may be required.

Pay Range

• Salary: $78,400 - $107,800 per year.
  • Note: This is a good faith estimate. Actual pay may vary based on geographic location, demonstrated skills, knowledge, experience, education, and certifications.
• Bonus: This job is eligible for a bonus incentive plan based on company and/or individual performance.

Company Information

• Humana, Inc. and its affiliated subsidiaries... (Further details on benefits and company information were not fully provided in the original text.)