Director, Quality Improvement

Become a part of our caring community and help us put health first
 The Director, Quality Improvement implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Director, Quality Improvement requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

The Director, Quality Improvement monitors quality investigations and compliance processes.

Role Overview:

• 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 related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance.
• Provides input into functions strategy.

Use your skills to make an impact
 

Required Qualifications

• Bachelor Degree 

• Louisiana-licensed registered nurse OR advanced practice registered nurse OR physician, OR physician's assistant or must be willing to obtain Certification in one of the following within 6 months of hire:  

  • Certified Professional in Health Care Quality (CPHQ) by the National Association for Health Care Quality (NAHQ) or 
  • Certified in Health Care Quality and Management (CHCQM) by the American Board of Quality Assurance and Utilization Review Providers  
• 5+ years of management experience in quality
• 5+ years of Supervisory People Management
• 5+ years’ experience in a fast-paced insurance or health care setting
• 3+ years’ 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 reside and conduct work in the state of Louisiana
• Must be available to travel to state meeting as needed by the business; up to 25% - this is a Hybrid role that will report to the office up to 3 days a week.
• Working knowledge of Value Based Contracting

Preferred Qualifications

Additional Information

Work-At-Home 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 required; wireless, wired cable or DSL connection is required.
• 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.

Additional Information

Interview Format

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.

SSN Alert:

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.

$126,300 - $173,700 per year

This 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.

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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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.