Manager, Provider Quality Improvement

🕒 2 dias atrás

🧀 Wisconsin – Remoto

🧀 Wisconsin – Remote

💵 $86.300 - $118.700 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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• Aberta há 2 dias.
• As vagas desta empresa costumam ser preenchidas em 21 dias.

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Humana

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1961

🏥 Saúde

🛡️ Seguros

⚕️ Seguro de Saúde

Healthcare • Insurance • Healthcare Insurance

A Humana é uma empresa de saúde dedicada a gerar um impacto positivo na saúde de indivíduos, comunidades e do sistema de saúde como um todo. Com foco em colocar a saúde em primeiro lugar, a Humana atende a uma ampla e diversa gama de populações, incluindo idosos e militares, oferecendo planos Medicare Advantage (HMO, PPO e PFFS). A Humana está comprometida em promover uma cultura de pertencimento e respeito mútuo, oferecendo benefícios competitivos e flexíveis para garantir a segurança financeira de seus funcionários e de suas famílias. A empresa se orgulha de criar um ambiente de trabalho inclusivo, no qual todos têm a oportunidade de ter sucesso.

Descrição

• Lead collaborative provider survey question development, analysis, and improvement interventions • Audit provider-related activities to ensure policies and processes are followed • Refer provider quality issues to external regulatory entities based on complaints or incident reports • Intake, review, and follow up with providers on statements of deficiencies issued by regulatory entities • Collaborate across the organization on provider-related activities and process improvement interventions • Analyze and report provider quality metrics and trends to leadership • Develop the annual quality management program description, work plan, and evaluation • Facilitate the quarterly Provider Advisory Committee • Monitor, analyze, and report incident management performance, trends, risks, timeliness, recurrence, investigation outcomes, and quality metrics • Develop and implement corrective actions, prevention strategies, and quality improvement initiatives based on incident data, root cause analyses, audit findings, and performance results • Report to the Director of Quality Improvement

🎯 Requisitos

• Bachelor's Degree • 3 or more years of people management experience • 5 or more years of experience in WI long-term care programs, Family Care or Family Care Partnership • 3 or more years of experience in Quality Management • 1 year of experience in provider relations and education • Must reside in WI or in a bordering state • 1 year of experience developing surveys and audit tools (preferred) • Experience in program development (preferred) • Experience engaging primary care providers such as hospitals, physicians, behavioral health practitioners (preferred) • Minimum download speed of 25 Mbps and upload speed of 10 Mbps for home internet • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefícios

• Bonus incentive plan based upon company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Home-based work arrangement • Dedicated home workspace and internet requirements to support remote work • Occasional travel to Humana offices for training or meetings

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