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

The Quality Improvement Professional 2 implements quality improvement programs for Michigan Medicaid, including annual program description, work plan, and annual evaluation. The Quality Improvement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

POSITION RESPONSIBILITIES:

• Monitor quality investigations and compliance processes
• Manage quality management system, department SharePoint, and department reporting
• Audit processes as needed for compliance
• Complete and submit reports to CMS and state regulators as required for clinical studies
• Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas
• Make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
• Follow established guidelines/procedures
• Additional responsibilities based on business need

Use your skills to make an impact
 

REQUIRED QUALIFICATIONS:

• Must reside in MI or within 40 miles of the border in Indiana or Ohio.
• Bachelor's Degree
• 2 years of experience in quality management and/or quality improvement
• Strong understanding of HEDIS and other national quality measures
• Knowledge of Microsoft Office programs to include Word Excel and PowerPoint
• Strong collaboration and communication skills
• Excellent analytical and presentation skills
• Strong organizational skills

PREFERRED QUALIFICATIONS:

• Over 2 years of experience in quality management and quality improvement
• Knowledge of complex medical, technical, statistical, and process components relating to quality management, including rapid-cycle improvement, data mining, accreditation, regulatory guidelines, and health field or business requirements or both
• Knowledge of NCQA, CMS and State requirements
• Understanding of Medicaid provider operational processes, and provider’s challenges and barriers to improving quality
• CHPQ or CHCQM Certification
• Strong knowledge in MS Access

Additional Information

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 required; 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.

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.

 

$65,000 - $88,600 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers