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

The Quality Improvement Coordinator 2 implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Quality Improvement Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. The Quality Improvement Coordinator 2 monitors quality investigations and compliance processes. Manages quality management system, department SharePoint, and department reporting. Audits processes as needed for compliance. Completes and submits reports to CMS and state regulators as required for clinical studies. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

• Investigate the state reported incidents including background, causative factors, follow up and reporting to state.
• Inter departmental coordination to investigate the reported incidents to find out the root causes and resolutions.
• Implement quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation.
• Perform various activities and moderately complex administrative/ operational and customer support assignments.
• Monitors quality investigations and compliance processes.
• Manages quality management systems, department SharePoint and department reporting.
• Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

 

Use your skills to make an impact
 

Required Qualifications

• Prior experience in a fast paced insurance or health care setting
• Experience in provider relations and education
• Understanding of healthcare quality measures STARS, HEDIS, etc.
• Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint
• Proven analytical skills
• Excellent communication skills, both oral and written
• Strong relationship building skills
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Bachelor Degree
• Knowledge of Humana's internal policies, procedures and systems

Additional Information

Work from Home 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

 

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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.
• Humana will provide Home or Hybrid Home/Office associates 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.

 

Driver's License, Transportation, Insurance T