Quality Improvement Coordinator

Humana; North Carolina; Remote; USD 44,000 - 61,000; Full time

Job summary

Join a forward-thinking organization dedicated to health improvement as a Quality Improvement Coordinator. In this pivotal role, you will be instrumental in managing quality compliance processes and supporting quality improvement initiatives for a major Medicaid program. Your expertise in healthcare quality measures and strong organizational skills will help streamline operations and enhance team collaboration. This position offers a flexible work environment, allowing you to thrive while contributing to meaningful healthcare outcomes. If you are passionate about making a difference in the healthcare landscape and possess the drive to excel in a dynamic setting, this opportunity is perfect for you.

Benefits

Medical, Dental, and Vision Benefits

401(k) Retirement Savings Plan

Paid Time Off

Short-term and Long-term Disability

Life Insurance

Flexible Start and Stop Times

Remote Learning Training

Internet Expense Payment for Certain States

Qualifications

• 1+ year experience in a fast-paced health insurance environment.
• Comprehensive knowledge of Microsoft Office Suite and healthcare quality measures.

Responsibilities

• Coordinate inter-departmental quality committees and maintain documentation.
• Monitor quality compliance processes and assist in prioritizing requests.

Skills

Healthcare Quality Measures (HEDIS, CMS, NCQA)

Communication Skills

Organizational Skills

Detail-oriented

Meeting Minutes and Note Taking

Education

Experience in Health Insurance Environment

Experience in Medicaid Managed Care

Tools

Microsoft Office Suite (Word, Excel, PowerPoint, Access)

SharePoint

Microsoft Teams

Job description

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

The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The Quality Improvement Coordinator 3 performs advanced administrative, operational, and Quality program and team support duties that require independent initiative and judgment.

The Quality Improvement Coordinator 3 monitors quality compliance processes and manages the quality management system, department SharePoint, Teams sites and departmental reporting. Decisions are typically focused on methods, tactics and processes for completing administrative tasks and projects. This role regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge and other duties as assigned.

Responsibilities:

• Coordinates inter-departmental quality committees and workgroups; as well as materials, agendas, minutes and meeting invites
• Maintains department SharePoint and Teams sites information and folders
• Assists in prioritizing requests for information in regard to the Quality program, procedures, policies and deliverables
• Monitors and tracks teams commitments and time spent on program requirements specific to collaborative projects
• Performs outreach calls to members and providers related to Quality Improvement efforts.

Use your skills to make an impact

Required Qualifications:

• 1+ year prior experience in a fast-paced health insurance environment
• Understanding of healthcare quality measures HEDIS, CMS, NCQA, etc.
• Comprehensive knowledge of Microsoft Office Suite (Word, Excel, PowerPoint, Access)
• Experience in Medicaid managed care
• Excellent communication skills, both oral and written
• Highly organized and detail-oriented
• Previous experience taking meeting minutes and note taking
• Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Preferred Qualifications:

• Strong relationship building skills
• Detail oriented and comfortable working with tight deadlines in a fast-paced environment
• Ability to work independently under general instructions, self-directed and motivated
• Experience with external provider communications, procurement processing and timesheet management.
• Experience in documentation creation and updates such as policies, meeting minutes, process flow charts, etc.

Additional information:

• Schedule: Monday to Friday from 8 am to 5 pm. ET Overtime as per business needs. Open for flexible Start and Stop times. Able to work in the Eastern Time Zone
• This position is an Hourly position, traditional week will be 40 hours
• Training: 3 week remote learning
• Work Location (Address): Work at Home/Remote Nationwide. Able to work in the Eastern Time Zone

Work at Home Guidance:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Scheduled Weekly Hours:

40

Pay Range:

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $44,900 - $60,200 per year

Description of Benefits:

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us:

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer:

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.