Senior Quality Improvement Leader - Remote Medicaid

Humana; Columbia (SC); Remote; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Medical, dental & vision benefits

401(k) retirement savings

Job summary

Humana in South Carolina seeks a Senior Quality Improvement Professional to lead provider-focused initiatives that improve clinical quality, provider performance, and member experience under the Humana Healthy Horizons in SC Medicaid Plan.

You will manage projects, analyze diverse data sources, and drive measurable improvements, collaborating with internal teams and external partners to advance a culture of quality and performance excellence.

Qualifications

• Bachelor's degree required; SC residency preferred.
• 3+ years healthcare quality improvement experience (HEDIS/CAHPS or related measures).
• 2+ years provider-facing experience with quality/performance initiatives.
• Managed care exposure, preferably within SC Medicaid.
• Proficient in Excel; able to analyze data and communicate trends.

Responsibilities

• Lead cross-functional quality improvement initiatives and education.
• Analyze provider performance data to identify opportunities and drive solutions.
• Lead and participate in committees focused on HEDIS, CAHPS, and other measures.
• Collaborate with internal/external stakeholders to close care gaps.

Skills

Quality improvement

HEDIS/CAHPS

Provider-facing

Excel

Data analysis

Stakeholder engagement

Independent work

Education

Bachelor's degree

Advanced Degree (preferred)

Tools

Excel

Reporting/visualization tools

Job description

Humana in South Carolina seeks a Senior Quality Improvement Professional to lead provider-focused initiatives that improve clinical quality, provider performance, and member experience under the Humana Healthy Horizons in SC Medicaid Plan.

You will manage projects, analyze diverse data sources, and drive measurable improvements, collaborating with internal teams and external partners to advance a culture of quality and performance excellence.