Remote Quality Improvement Lead – Medicaid & Member Experience

Humana; South Carolina; Remote; USD 78,000 - 108,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement plan

Paid time off

Parental leave

Short/long-term disability

Life insurance

Job summary

Humana is seeking a Senior Quality Improvement Professional to lead provider-focused, cross-functional initiatives to improve clinical quality, provider performance, and member experience for the South Carolina Medicaid plan.

You will develop and implement quality improvement initiatives, analyze performance data, and drive sustainable improvements with a focus on HEDIS/CAHPS metrics and collaborative stakeholder engagement.

Qualifications

• Bachelor's degree required.
• 3+ years healthcare quality improvement experience (HEDIS/CAHPS or related).
• 2+ years provider-facing quality/performance improvement work.
• Managed care experience, SC Medicaid preferred.
• Proficient in Excel; able to analyze data and communicate findings.
• Strong communication and stakeholder engagement; able to work independently.

Responsibilities

• Partner with teams to implement quality improvement strategies and track outcomes.
• Analyze provider-level data to identify improvement opportunities and prioritize interventions.
• Lead cross-functional quality improvement workgroups focused on key measures (HEDIS/CAHPS).
• Collaborate with stakeholders to advance quality and member experience initiatives.
• Lead CAHPS/ECHO and other member-experience initiatives with targeted actions.
• Document improvement plans, interventions, outcomes, and corrective actions for reporting.

Skills

Healthcare quality improvement

HEDIS/CAHPS experience

Excel proficiency

Stakeholder engagement

Independent work

Education

Bachelor's degree

Tools

Reporting/Visualization tools

Job description

Humana is seeking a Senior Quality Improvement Professional to lead provider-focused, cross-functional initiatives to improve clinical quality, provider performance, and member experience for the South Carolina Medicaid plan.

You will develop and implement quality improvement initiatives, analyze performance data, and drive sustainable improvements with a focus on HEDIS/CAHPS metrics and collaborative stakeholder engagement.