Director, Quality Improvement

Humana Inc; Baton Rouge (LA); Remote; USD 126,000 - 174,000; Full time

Job summary

Join a forward-thinking company as a Director of Quality Improvement, where your leadership will drive impactful quality initiatives across healthcare services. This role offers the chance to leverage your extensive experience in healthcare quality management, ensuring compliance and enhancing performance. You will play a pivotal role in shaping departmental strategies and improving patient outcomes. With a competitive salary and comprehensive benefits, this position not only emphasizes your professional growth but also your commitment to health-first initiatives. Embrace the opportunity to make a significant difference in the lives of diverse populations.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Paid Time Off

Disability Insurance

Life Insurance

Qualifications

• 5+ years of management experience in quality within healthcare.
• Understanding of healthcare quality measures like STARS and HEDIS.

Responsibilities

• Manage quality management system and conduct compliance audits.
• Submit reports to CMS and state regulators for clinical studies.

Skills

Management Experience

Healthcare Quality Measures Understanding

Analytical Skills

Communication Skills

Relationship-Building Skills

Proficiency in Microsoft Office Suite

Education

Bachelor's Degree

Master's Degree

Tools

Power BI

SharePoint

Job description

Director, Quality Improvement page is loaded

Director, Quality Improvement

Apply locations: Remote, Louisiana (New Orleans, Metairie, Baton Rouge)

Time type: Full time

Posted on: Posted 3 Days Ago

Job requisition ID: R-374772

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

The Director, Quality Improvement is responsible for implementing quality improvement programs across all lines of business, including developing annual program descriptions, work plans, and evaluations. This role requires a deep understanding of organizational capabilities and their interrelations within the function or segment. The Director monitors quality investigations and ensures compliance processes are followed.

Role Overview:

1. Manage the quality management system, department SharePoint, and reporting; conduct audits for compliance.
2. Complete and submit reports to CMS and state regulators as required for clinical studies.
3. Make decisions related to new or updated programs, large-scale projects, and strategic planning to drive goals and improve performance.
4. Contribute to the development of departmental strategies.

Use your skills to make an impact

Required Qualifications:

• Bachelor's Degree
• Louisiana-licensed registered nurse, advanced practice registered nurse, physician, physician's assistant, or willing to obtain certification within 6 months:
• CPHQ by NAHQ or
• CHCQM by the American Board of Quality Assurance and Utilization Review Providers
• 5+ years of management and supervisory experience in quality
• 5+ years in a fast-paced insurance or healthcare setting
• 3+ years in provider relations and education
• Understanding of healthcare quality measures (STARS, HEDIS, etc.)
• Proficiency in Microsoft Office Suite
• Proven analytical and communication skills
• Strong relationship-building skills
• Residency in Louisiana and willingness to travel up to 25%
• Working knowledge of Value-Based Contracting

Preferred Qualifications:

• Master's Degree
• Additional certifications in healthcare quality management (e.g., CPHQ, CHCQM)
• Knowledge of Humana's policies and systems
• Six Sigma or similar quality management training
• Experience with Power BI and pivot tables

Additional Information:

• Work-At-Home Requirements: internet speed of at least 25 Mbps download and 10 Mbps upload; dedicated workspace; compliance with HIPAA and PHI security.
• Interview process may include HireVue assessments.
• Travel up to 25% for meetings and training.

Compensation and Benefits:

Annual salary: $126,300 - $173,700, plus bonus potential. Benefits include medical, dental, vision, 401(k), paid time off, disability, life insurance, and more.

About Humana:

Humana Inc. is dedicated to health first initiatives, serving diverse populations through insurance and healthcare services, aiming to improve quality of life.

Equal Opportunity Employer:

Humana values diversity and inclusion, ensuring non-discriminatory employment practices and affirmative action in accordance with applicable laws.