Become a part of our caring community and help us put health first

　　Quality Improvement Manager will implement and monitor quality improvement program components, including annual program description, work plan, and annual evaluation. The Quality Improvement Manager works within specific guidelines and procedures, receives assignments in the form of objectives and determines approach, resources, schedules and goals. The Quality Manager will play a key role in the NCQA accreditation process.

　　The Manager, Quality Improvement ensures the Quality Assessment and Performance Improvement (QAPI) program for Humana Healthy Horizons in Oklahoma operates effectively.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, QAPI committee and evaluation, etc.Drives quality improvement (QI) efforts. Provides support to staff and communicates daily QI functions.Responsible for monitoring and implementing activities related to quality improvement and compliance for both behavioral and physical health.Coordinates resources and tactical operations for improvement projects and EPSDT-related initiatives.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.Coordinate 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, the Oklahoma Health Care Authority, and other entities to maintain quality operations and improve health outcomes.

　　Required Qualifications

　　Must reside in the state of Oklahoma, preferably Oklahoma City2+ yrs experience in managed care or health care settingsStrong understanding of healthcare quality measures, HEDIS, CAHPS, STARS ratingsUnderstanding of Quality Improvement tools and methodologies (PDSA, root cause analysis, IHI Model for Improvement, etc.)2+ yrs Quality Improvement experienceExperience in direct provider and/or member engagementExperience managing teams (including hiring, training, coaching)Demonstrated ability to manage multiple projects and meet deadlinesExcellent communication skills, both oral and written.Comprehensive knowledge of Microsoft Office suite; Microsoft Word, Excel and Power Point

　　Preferred Qualifications

　　Medicaid experienceCPHQ (Certified Professional in Healthcare Quality) Certification

　　Additional Information

　　Workstyle: Hybrid; A combination of remote and Humana's Oklahoma City location.

　　Work at Home Criteria

　　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.

　　Interview Format

　　As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire 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.

　　Scheduled Weekly Hours

　　40

　　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.