Senior Quality Improvement Professional

Humana Inc; Orlando (FL); Remote; USD 78,000 - 108,000; Full time

Job summary

A leading health company in Florida seeks a Senior Quality Improvement Professional to drive quality improvement initiatives. This role involves analyzing data and ensuring compliance with healthcare benchmarks, while leading collaborative efforts to enhance clinical outcomes. The ideal candidate will have relevant experience and a strong background in data analysis and healthcare quality measures.

Benefits

Bonus incentive plan

Flexible working arrangements

Qualifications

• 2+ years of behavioral health experience required.
• Experience with healthcare quality measures such as CAHPS, NCQA, HEDIS.
• Ability to manipulate data in Excel.

Responsibilities

• Ensures benchmarks and deliverables for Quality Improvement projects are met.
• Analyzes data and reports using quality improvement tools.
• Leads internal and external workgroups.

Skills

Data analysis

Communication

Project management

Quality improvement methodologies

Education

Bachelor's degree in social service or behavioral health

Master's degree in healthcare or behavioral health (preferred)

Job description

Job Profile

Senior Quality Improvement Professional

Job Level

Senior Professional

Become a part of our caring community and help us put health first

Humana Healthy Horizons in Florida is seeking a Senior Quality Improvement Professional who will be an integral part of the Florida Quality Improvement Department. This role will collaborate with internal and external customers to complete fast-paced and time sensitive projects.

The Senior Quality Improvement Professional:

• Ensures the Florida Agency for Healthcare Administration benchmarks, goals and deliverables for Quality Improvement clinical and non-clinical performance projects are met.
• Researches, gathers information and analyzes data in an expedited timeframe and uses QI tools and templates to report out in cross-functional workgroups/subgroups using the tenants of QI Science.
• Leads internal and external workgroups for the collaborative as directed.
• Works independently, sometimes in ambiguous situations, and work may be performed with minimal direction.
• Has additional responsibilities based on business needs.

Use your skills to make an impact

Required Qualifications:

• Bachelor's degree in a social service or behavioral health related field.
• Minimum of 2 years of behavioral health experience.
• Understanding of healthcare quality measures such as CAHPS, NCQA, HEDIS, etc.
• Experience performing moderate to complex data analysis.
• Experience managing and prioritizing multiple project deadlines.
• Experience giving presentations to both internal and external stakeholders with excellent oral and written communication skills.
• Ability to manipulate data in Excel and experience using Microsoft Word and PowerPoint to create documents and deliver presentations.
  

Preferred Qualifications

• Quality improvement experience.
• Master's degree in healthcare or behavioral health related field.
• Experience with QI methodologies (i.e., IHI model of improvement) and familiarity with QI Tools and reporting (i.e., FMEA, PDSA, DMAIC workflows/diagrams, root cause analysis).
• Certified Professional in Healthcare Quality (CPHQ).
• Previous Medicaid Health Plan quality experience.

Additional Information:

• Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
• Work Location: must reside in Florida.
• Typical work days/hours: Monday – Friday, 8:30 am – 5:00 pm EST.

WAH Internet Statement

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.

HireVue

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. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Limited Geography Remote - This is a remote position but located within a specific geography.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.$78,400 - $107,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Referral Bonus Information

This requisition is not eligible for a referral bonus.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.