Associate Director, Quality Improvement

Job not on LinkedIn

🔥 0 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $115.2k - $158.4k / year

⏰ Full Time

🟠 Senior

👔 Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • 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

• Work with clinical, health services, compliance, process improvement, and member/provider satisfaction departments for Ohio Medicaid • Implement quality improvement programs • Develop and execute enterprise-wide strategy in clinical quality areas across business lines • Identify and resolve complex technical and operational problems within departments • Lead multiple associates and highly specialized professional associates • Align Quality Associates and Population Health Stream strategies • Lead MPS measures by population stream and strategies to mitigate penalties • Lead QBA measures and strategies related to membership assignment performance • Oversee HEDIS project deliverables and drive results and improvement by population stream • Oversee CAHPS project deliverables and impact across children, adults, behavioral health, maternal health, and chronic conditions • Provide oversight of Cross-stream Quality Withhold collaborative efforts • Lead vendor and provider engagement from a Quality perspective • Maintain quality documentation, including policies/procedures, committee minutes/materials, and program documents • Lead efforts to maintain NCQA and EQRO compliance • Maintain confidential information in accordance with policies and state and federal confidentiality laws, rules, and regulations

🎯 Requirements

• 4 or more years of experience working within Medicaid • 2 or more years of current or previous leadership experience • Experience in Quality Improvement/Process Improvement in the healthcare field • Understanding of cultural factors influencing health outcomes and implementing culturally competent improvement interventions • Demonstrated skills in quality improvement concepts, healthcare data analysis, data mining methods, and identifying population health issues, trends, and health disparities using healthcare data sources • Understanding of value-based payment models that reward quality improvement • Excellent communication and presentation skills, including communicating technical/financial details to Senior VP-level leadership and/or Senior Government officials • Critical-thinking and initiative skills • Ohio residency strongly preferred; non-Ohio candidates considered if within driving commute to Columbus, Ohio • Associate's Degree in practical nursing, health administration, health policy or business or equivalent work experience (preferred) • CPHQ Certification (preferred) • Knowledge of QI methodologies, including IHI model of improvement, FMEA, KDD, workflows/diagrams, and root cause analysis (preferred) • Knowledge of Humana's internal policies, procedures, and systems (preferred) • Ability to work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information • Minimum home internet speed of 25 Mbps download and 10 Mbps upload

🏖️ Benefits

• Bonus incentive plan based on 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 or Hybrid Home/Office employees receive work-from-home flexibility • Up to 20% travel to Humana office locations and external agencies in Ohio • Internet service requirement/support for home work: minimum 25 Mbps download and 10 Mbps upload • Dedicated workspace arrangement for protecting member PHI/HIPAA information