Senior Quality T
Posted 2025-03-15
Remote, USA
Full-time
Immediate Start
Become a part of our caring community and help us put health firstAre you the right candidate for this opportunity Make sure to read the full description below. The Senior Quality Compliance Professional uses quality compliance and improvement tools and methodology to assess, implement, monitor and evaluate activities to continuously improve compliance with EPSDT services and close gaps in care 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 required to understand compliance with quality measures and be able to analyze and interpret healthcare data/information in order to develop strategy and build interventions to close gaps in care. More specifically, the role will be focusing on increasing EPSDT screening / childhood immunization rates, improve access to pregnancy related services and work on additional projects aligning with OHCA priorities. Identifies and coordinates assistance for member needs specific to maternal/child health and EPSDT; Analyses immunization data and contributes to strategy development to address gaps in care; Participate in EPSDT, maternal health and child quality performance improvement projects (PIPs); Interfaces with care managers and pregnancy related services coordinators, the health equity team, and represents the department in EPSDT related events with community partners. Senior Quality Compliance Professional must meet one of the following requirements: Master's degree in health services, public health, or health care administration or another related field OR Certified Professional in Health Care Quality (CPHQ) OR Certified Health Care Quality Management (CHCQM) Must have at least 3 years of experience in either delivering EPSDT services OR Health Care Quality Improvement Must have comprehensive knowledge of Microsoft Office Outlook, Word and PowerPoint Intermediate level of Excel is required (experience with pivot tables, charts, formulas) Advanced Excel ? Understanding of healthcare quality measures (example HEDIS) Knowledge and experience of EPSDT and Child Health Services (ie. 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: wireless, wired cable or DSL connection is suggested. 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. 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. This incentive opportunity is based upon company and/or individual performance. 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. 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. 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 . 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.
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