Quality Improvement Coordinator

Humana; West Virginia; Remote; USD 44,000 - 61,000; Full time

Job summary

Join a forward-thinking company dedicated to health and wellness as a Quality Improvement Coordinator. In this dynamic role, you will support the Ohio Medicaid program by ensuring quality compliance and managing essential documentation. Your expertise in healthcare quality measures and strong communication skills will be crucial as you coordinate inter-departmental committees and track program commitments. This position offers the flexibility of remote work while being part of a caring community that values your contributions. If you're passionate about making an impact in healthcare, this opportunity is perfect for you.

Benefits

Flexible Start and Stop Times

Remote Work Options

Comprehensive Benefits

Training Program

Qualifications

• 1+ year experience in a fast-paced health insurance environment.
• Understanding of healthcare quality measures like HEDIS and CMS.

Responsibilities

• Coordinates inter-departmental quality committees and maintains documentation.
• Monitors quality compliance processes and manages departmental reporting.

Skills

Healthcare Quality Measures

Communication Skills

Organizational Skills

Detail-Oriented

Time Management

Education

Experience in Health Insurance

Experience in Medicaid Managed Care

Tools

Microsoft Office Suite

SharePoint

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.

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: 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.

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 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.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company.

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.