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

　　The Senior Quality Compliance Professional uses quality compliance and improvement tools and methodology to assess, implement, and evaluate activities to monitor and continuously improve EPSDT and maternal health services and rates for Oklahoma Medicaid enrollees.

　　The Senior Quality Compliance Professional has proven data analysis skills and a strong knowledge of EPSDT and maternal health requirements.

　　The Senior Quality Compliance Professional is frequently required to interpret and analyze data to identify new creative interventions to increase EPSDT screening rates, improve access to pregnancy related services, independently determine an appropriate course of action, and present these ideas/plans to governance teams/committees.

　　They assess educational needs of internal and external teams around EPSDT and maternal health services in order to develop and implement plans to increase knowledge.

　　The primary functions of this role include:

　　Ensure member receipt of all EPSDT/HealthChek Services;Ensure member receipt of maternal health and postpartum care;Promote family planning services;Promote preventive health strategies;Identify and coordinate assistance for identified member needs specific to maternal/child health and EPSDT;Interface with community partners and pregnancy related services coordinators;Participate in EPSDT, maternal health and child quality performance improvement efforts

　　Required Qualifications

　　Senior Quality Compliance Professional must meet one of the following requirements:

　　Unrestricted Registered Nurse in the State of Oklahoma ORPhysician's Assistant ORMaster's degree in health services, public health, or health care administration or another related field ORCertified Professional in Health Care Quality (CPHQ) ORCertified Health Care Quality Management (CHCQM)

　　Senior Quality Compliance Professional must meet all of the following:

　　At least 3 years of experience in either delivering EPSDT services OR Health Care Quality ImprovementKnowledge of EPSDT and Child Health ServicesKnowledge of Maternal and Pregnancy related servicesUnderstanding of healthcare quality measures (example HEDIS)Comprehensive knowledge of Microsoft Office Outlook, One Note, Visio, Word and PowerPointAdvanced Excel experience (pivot tables, charts, formulas)Excellent communication skills, both oral and written, ability to present to large groups.Must reside in Oklahoma, preferably Oklahoma City

　　Additional Information

　　This is a hybrid position. Availability to work in Humana's Oklahoma Tower facility in Oklahoma City.

　　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.