Humana
Healthcare Insurance
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
Quality Compliance Professional
51 minutes ago
🐎 Kentucky – Remote
💵 $71.1k - $97.8k / year
⏱ Part Time
🟡 Mid-level
🟠 Senior
🚔 Compliance
🦅 H1B Visa Sponsor
Humana
Healthcare Insurance
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
📋 Description
• participate in performance and quality improvement projects by implementing member and provider targeted interventions. • contribute to multidisciplinary committees required by NCQA and the State Contract. • conduct member outreach calls and medical record audits for provider compliance. • perform provider outreach to close care gaps and audit records to identify improvement opportunities. • complete and update reports, including State Reports and Kentucky Medicaid Quality Improvement Committee reports.
🎯 Requirements
• 3+ years of previous experience working with member outreach on quality and performance improvement activities. • 2+ years previous experience in healthcare quality improvement/quality operations. • Knowledge of HEDIS/CMS/Quality. • Experience with healthcare quality measures (example HEDIS, CAHPS). • Comprehensive knowledge of Microsoft Office Word, PowerPoint, intermediate Excel experience (pivot tables/filtering, charts, formulas).
🏖️ Benefits
• paid time off • 401(k) retirement savings plan • employee assistance program • business travel and accident
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