Humana
Quality Improvement Program Lead (National Medicaid Quality)
Humana, Juneau, Alaska, us, 99812
Location:
Juneau, AlaskaHumana Quality Improvement Program Lead (National Medicaid Quality)
Become a part of our caring community and help us put health firstHumana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end-to-end ownership of Humana Healthy Horizon's National Quality Improvement (QI) efforts, capability advancement activities, and the development and maintenance of QI frameworks and toolkits to support Quality associates throughout the line of business. The Quality Improvement Program Lead reports directly to the National Medicaid Quality Director.The Quality Improvement Program Lead exercises independent judgment and decision-making on complex issues within their scope, works under minimal supervision, and uses independent judgment requiring analysis of variable factors to determine the best course of action.Responsibilities include:Provides direction and oversight of Humana’s QI programs management model and improvement strategy for the Medicaid line of business at the national level.Develops policy and procedure, and defines/improves processes regarding quality measurement data collection and improvement methodology for all initiatives impacting Medicaid beneficiaries.Develops and maintains QI methodology playbooks and toolkits to support market QI efforts.Serves as the lead of the Quality related functions related to NCQA’s Health Equity Accreditation.Oversees related work plan development and evaluation of programs across all Medicaid markets.Nurtures relationships with national and market partners to expand and strengthen quality improvement efforts.Ensures organizational awareness of key developments and leads in the identification and development of national quality interventions.Drives interdepartmental collaboration to achieve business goals.Required Qualifications:3+ years of experience managing Healthcare Quality programs
OR
8+ years of quality improvement experience.5+ years of experience monitoring and improving quality measures (example HEDIS or CAHPS) in a quality improvement/quality management or office-based practice setting.Comprehensive knowledge of Microsoft Office Word, PowerPoint, Excel.Demonstrated ability to perform moderate to complex data analysis.Strong relationship building skills.Excellent written and oral communication skills.Ability to work independently under general instructions; must be self-directed and motivated.Preferred Qualifications:Certified Professional in Healthcare Quality (CPHQ)Experience with quality improvement methodology, preferably with the IHI Model for Improvement, Lean/Six Sigma, or other standardized methodology.Experience with SharePoint design.Advanced degree in business, healthcare, or related field.Strong business acumen.Work-At-Home Requirements:To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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.Associates 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 associates 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:Training:
Virtual in your home officeTravel:
up to 10%Work Hours:
Eastern Standard Time (EST)Scheduled Weekly Hours:
40Pay Range:
$112,400 - $154,900 per year. This job is eligible for a bonus incentive plan based upon company and/or individual performance.Description of Benefits:
Humana, Inc. and its affiliated subsidiaries offer 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.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 veteran status. 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 religion.
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Juneau, AlaskaHumana Quality Improvement Program Lead (National Medicaid Quality)
Become a part of our caring community and help us put health firstHumana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end-to-end ownership of Humana Healthy Horizon's National Quality Improvement (QI) efforts, capability advancement activities, and the development and maintenance of QI frameworks and toolkits to support Quality associates throughout the line of business. The Quality Improvement Program Lead reports directly to the National Medicaid Quality Director.The Quality Improvement Program Lead exercises independent judgment and decision-making on complex issues within their scope, works under minimal supervision, and uses independent judgment requiring analysis of variable factors to determine the best course of action.Responsibilities include:Provides direction and oversight of Humana’s QI programs management model and improvement strategy for the Medicaid line of business at the national level.Develops policy and procedure, and defines/improves processes regarding quality measurement data collection and improvement methodology for all initiatives impacting Medicaid beneficiaries.Develops and maintains QI methodology playbooks and toolkits to support market QI efforts.Serves as the lead of the Quality related functions related to NCQA’s Health Equity Accreditation.Oversees related work plan development and evaluation of programs across all Medicaid markets.Nurtures relationships with national and market partners to expand and strengthen quality improvement efforts.Ensures organizational awareness of key developments and leads in the identification and development of national quality interventions.Drives interdepartmental collaboration to achieve business goals.Required Qualifications:3+ years of experience managing Healthcare Quality programs
OR
8+ years of quality improvement experience.5+ years of experience monitoring and improving quality measures (example HEDIS or CAHPS) in a quality improvement/quality management or office-based practice setting.Comprehensive knowledge of Microsoft Office Word, PowerPoint, Excel.Demonstrated ability to perform moderate to complex data analysis.Strong relationship building skills.Excellent written and oral communication skills.Ability to work independently under general instructions; must be self-directed and motivated.Preferred Qualifications:Certified Professional in Healthcare Quality (CPHQ)Experience with quality improvement methodology, preferably with the IHI Model for Improvement, Lean/Six Sigma, or other standardized methodology.Experience with SharePoint design.Advanced degree in business, healthcare, or related field.Strong business acumen.Work-At-Home Requirements:To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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.Associates 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 associates 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:Training:
Virtual in your home officeTravel:
up to 10%Work Hours:
Eastern Standard Time (EST)Scheduled Weekly Hours:
40Pay Range:
$112,400 - $154,900 per year. This job is eligible for a bonus incentive plan based upon company and/or individual performance.Description of Benefits:
Humana, Inc. and its affiliated subsidiaries offer 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.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 veteran status. 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 religion.
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