Remote Quality Improvement Leader — SC Medicaid

Humana Inc; Columbia, Northern (SC, KY); Hybrid; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana Inc. is seeking a Senior Quality Improvement Professional to lead efforts to improve clinical quality and provider performance for the Humana Healthy Horizons in South Carolina Medicaid Plan.

This role involves developing cross-functional quality initiatives, evaluating processes and outcomes, and driving measurable improvements. You will manage complex projects, analyze diverse data, and influence strategic decisions with data-driven insights.

Qualifications

• Bachelor's degree required.
• South Carolina residency required.
• 3+ years of healthcare quality improvement experience, including HEDIS, CAHPS, or related performance measures.
• 2+ years of provider-facing experience supporting quality and performance improvement programs.
• Managed care experience, preferably within South Carolina Medicaid.
• Experience analyzing and interpreting healthcare performance data.
• Strong communication, relationship-building, and stakeholder engagement skills.
• Demonstrated ability to work independently, manage multiple priorities, and execute strategic initiatives.

Responsibilities

• Partner with provider teams to implement quality improvement strategies, education, training and performance reporting.
• Analyze performance data to identify improvement opportunities and develop targeted interventions.
• Lead and participate in cross-functional quality improvement workgroups to improve HEDIS, CAHPS, and other measures.
• Collaborate with internal and external stakeholders to advance quality and member experience goals.
• Lead provider-focused strategies supporting CAHPS/ECHO and other member experience initiatives.
• Use your skills to make an impact.

Skills

Communication skills

Relationship-building

Stakeholder engagement

Independent work

Project management

Education

Bachelor's degree

Job description

Humana Inc. is seeking a Senior Quality Improvement Professional to lead efforts to improve clinical quality and provider performance for the Humana Healthy Horizons in South Carolina Medicaid Plan.

This role involves developing cross-functional quality initiatives, evaluating processes and outcomes, and driving measurable improvements. You will manage complex projects, analyze diverse data, and influence strategic decisions with data-driven insights.