Quality Compliance Professional

Humana; West Virginia; Remote; USD 15,000 - 25,000; Part time

Job summary

A leading company seeks a Quality Compliance Professional Intern to engage with Kentucky Medicaid team. The role involves quality improvement projects, member outreach, and is tailored for eligible military service members or spouses. Networking opportunities are included, combining training with practical experience.

Benefits

Work from home equipment provided

Networking opportunities

Qualifications

• Eligible military service members or spouses for SkillBridge or Military Spouse Fellowship.
• 3+ years experience in member outreach on quality/performance improvement.
• 2+ years healthcare quality improvement experience.

Responsibilities

• Participate in quality improvement projects and support Kentucky market quality activities.
• Conduct medical record audits for provider compliance.
• Engage in member outreach and complete reporting tasks.

Skills

Member outreach

Quality improvement

Communication

Relationship building

Independent work

Education

Bachelor’s degree

Tools

Microsoft Excel

Job description

Join to apply for the Quality Compliance Professional role at Humana

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

Job Summary: Are you a transitioning military service member or a Military Spouse looking for an internship that supports the goal to put health first?

The Quality Compliance Professional intern will utilize Humana's training and mentorships and engage formerly acquired skills to work with Humana’s Kentucky Medicaid team by participating in performance and quality improvement projects including implementing member and provider targeted interventions to improve health outcomes and member and provider experiences. If interested, you must confirm eligibility for the Department of Defense SkillBridge Internship or Hiring our Heroes Military Spouse Fellowship.

The DOD SkillBridge Internship Program offers transitioning military service members civilian work experience for 90-180 days upon approval. The Military Spouse Fellowship Program connects spouses with various professional opportunities.

Networking opportunities are provided during the Internship or Fellowship. Note that full-time employment is not guaranteed upon completion due to location and other factors.

The Quality Compliance Professional 2 Intern will participate in quality improvement projects, contribute to multidisciplinary committees, and support Kentucky market quality activities, aligning with organizational strategies.

This includes but is not limited to:

• Member outreach calls
• Medical record audits for provider compliance
• Provider outreach to close care gaps
• Quality document updates
• Quality Improvement Committee meetings
• Reporting (State Reports, Kentucky Medicaid Quality Improvement reports)
• Building strong relationships
• Excellent communication skills
• Ability to work independently

Required Qualifications:

• Eligible military service members or spouses for SkillBridge or Military Spouse Fellowship
• 3+ years experience in member outreach on quality/performance improvement
• 2+ years healthcare quality improvement experience
• Knowledge of HEDIS/CMS/Quality measures
• Proficiency in Microsoft Office, especially Excel

Preferred Qualifications:

• Bachelor’s degree
• Experience with Medicaid populations
• CPHQ certification
• Quality improvement experience in healthcare settings

Additional Information:

Workstyle: Remote Work at Home
Location: Kentucky, must reside in Eastern Time Zone
Schedule: 8:00 AM - 4:30 PM ET
Travel: Quarterly meetings in Louisville and provider visits within Kentucky

Work at Home Guidance: Internet speed requirements are specified; equipment will be provided. Employees must work from a dedicated space.

Interview Process: Using HireVue technology.

SSN Alert: Applicants may be asked to provide SSN via a secure process.

While remote, occasional travel to Humana offices may be required.

About Us: Humana Inc. is committed to health first, serving diverse communities and populations.

Equal Opportunity Employer: Humana values diversity and inclusion in employment practices.

Details:

• Seniority level: Internship
• Employment type: Part-time
• Job function: Quality Assurance
• Industries: Insurance