Manager, Quality Improvement

at Humana in Dover, Delaware, United States
Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Manager, Quality Improvement who will lead a team to implement quality improvement programs for Indiana Medicaid including annual program description, work plan, and annual evaluation. The Manager, Quality Improvement works within specific guidelines and procedures, applies advanced technical knowledge to solve moderately complex problems, receives assignments in the form of objectives and determines approach, resources, schedules and goals.
+ Leads the Quality Improvement team to oversee timely deliverables.
+ Supports the Quality Improvement Director on operating an NCQA compliant program.
+ Supports the implementation and monitoring of program documents such as program description, work plan, and evaluation.
+ Drives quality improvement (QI) efforts. Provides support to staff and communicates daily QI functions.
+ Monitors and implements activities related to quality improvement and compliance for both behavioral and physical health in partnership with the health equity team.
+ Tracks HEDIS measures with the assistance of the Quality Data Analyst to ensure the plan meets the goals set for the quality withhold measures.
+ Manages department reporting; completes and submits state or federal reports as required. Audits data/processes as needed for compliance.
+ Conducts briefings and area meetings. Keeps committee meetings minutes.
+ Coordinates with interdisciplinary teams (i.e., population health, community engagement, etc.) to integrate quality improvement processes and evidence-based practices.
+ Coordinates with relevant internal/external stakeholders, providers, and other entities to maintain quality operations and improve health outcomes.
+ Requires cross departmental collaboration and conducts briefings and area meetings.
Use your skills to make an impact Required Qualifications + Bachelor's Degree.
+ 2 or more years of experience leading a team of direct reports.
+ 3-5 years of quality experience in a health care, health insurance, or public health setting.
+ Experience with relationship building with external partners, i.e. providers, members, community service providers.
+ Understanding of Quality Improvement tools and methodologies ( PDSA , root cause analysis, IHI Model for Improvement, etc.).
+ Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint.
Preferred Qualifications + Understanding of healthcare quality measures STARS , HEDIS , etc.
+ Master of Health Administration, Master of Public Health or CPHQ (Certified Professional in Healthcare Quality) Certification.
Additional Information: + Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
+ Work Location: Indiana resident preferred.
+ Typical Work Days/Hours: Monday – Friday, 8:00 am – 5:00 pm EST .
+ Direct Reports: up to 7 direct reports.
WAH Internet Requirements 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.
Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
+ Health benefits effective day 1
+ Paid time off, holidays, volunteer time and jury duty pay
+ Recognition pay
+ 401(k) retirement savings plan with employer match
+ Tuition assistance
+ Scholarships for eligible dependents
+ Parental and caregiver leave
+ Employee charity matching program
+ Network Resource Groups (NRGs)
+ Career development opportunities
HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
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Nationwide Remote – This is a remote nationwide position.
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.$76,800 – $105,800 per yearThis 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 and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer It is the policy of ?Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of ?Humana?to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or
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