External LTSS QA Manager (Remote, MI)

Humana Inc; Michigan; Hybrid; USD 104,000 - 143,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Short-term and long-term disability

Life insurance

Job summary

Humana Inc. seeks a Manager, Quality Assurance for the External LTSS Oversight Team to lead QA professionals ensuring LTSS eligibility and service authorization align with state and Humana requirements.

You will collaborate with external partners, monitor daily operations, and develop policies to maintain compliance, with travel up to 25%. This remote role includes occasional Detroit office visits and regular leadership communications.

Qualifications

• Must reside in Michigan.
• Active, unrestricted RN or LBSW license in Michigan.
• 3+ years of professional experience with complex populations, home-based services or managed care.
• 2+ years of management or supervisory experience.
• Proficiency in Microsoft Office (Excel, PowerPoint) and data trend analysis.
• Excellent oral and written communication with strong interpersonal skills.

Responsibilities

• Lead and oversee the External Oversight Team to ensure LTSS eligibility and service authorization compliance.
• Plan daily operations, allocate resources, and drive cross-department collaboration.
• Develop and implement policies to meet state and federal requirements.
• Provide real-time training to external partners and internal teams.
• Monitor performance metrics and report findings to leadership.

Skills

Team leadership

Data analysis

Communication skills

Problem solving

Tools

Microsoft Office

Excel

PowerPoint

Job description

Humana Inc. seeks a Manager, Quality Assurance for the External LTSS Oversight Team to lead QA professionals ensuring LTSS eligibility and service authorization align with state and Humana requirements.

You will collaborate with external partners, monitor daily operations, and develop policies to maintain compliance, with travel up to 25%. This remote role includes occasional Detroit office visits and regular leadership communications.