Quality Improvement Professional 1

Profile

Description

The Quality Improvement Professional 1 implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Quality Improvement Professional 1 work assignments are often straightforward and of moderate complexity.

Responsibilities

The Quality Improvement Professional 1 monitors quality investigations and compliance processes. 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. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

Required Qualifications

Bachelor's degree

Prior experience in a fast paced insurance or health care setting

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 be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Knowledge of Humana's internal policies, procedures and systems

Additional Information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com