Senior Quality Improvement Lead - Remote

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

Job summary

Humana Inc. is seeking a Senior Quality Improvement Professional to lead provider-focused quality initiatives within the Humana Healthy Horizons in South Carolina Medicaid Plan.

The role involves developing and implementing cross-functional improvements, analyzing data, and driving measurable outcomes to enhance care quality and member experience. Reporting to the Quality Improvement Director, you will collaborate with internal and external stakeholders, manage complex projects, and influence

Qualifications

• Bachelor's degree required.
• 3+ years healthcare quality improvement experience, including HEDIS/CAHPS.
• 2+ years of provider-facing experience supporting quality and performance initiatives.
• Proficiency in Excel and experience using reporting/visualization tools to analyze and communicate performance trends.

Responsibilities

• Lead provider-focused quality improvement initiatives across payor, provider engagement, network, and contracting teams.
• Analyze provider-level performance data and healthcare data sources to identify improvement opportunities and translate findings into recommendations.
• Lead cross-functional quality improvement workgroups focused on HEDIS, CAHPS, and other measures with actionable plans.
• Collaborate with internal and external stakeholders to strengthen member outreach, care-gap closure, and quality reporting.

Skills

Quality improvement

HEDIS/CAHPS

Data interpretation

Stakeholder engagement

Education

Bachelor's degree

Tools

Excel

Job description

Humana Inc. is seeking a Senior Quality Improvement Professional to lead provider-focused quality initiatives within the Humana Healthy Horizons in South Carolina Medicaid Plan.

The role involves developing and implementing cross-functional improvements, analyzing data, and driving measurable outcomes to enhance care quality and member experience. Reporting to the Quality Improvement Director, you will collaborate with internal and external stakeholders, manage complex projects, and influence