Clinical Competency & Quality Nurse

Job Summary The Care Integration Clinical Competency & Quality Nurse is a Center of Excellence (CoE) position responsible for ensuring the clinical quality and provider & patient engagement effectiveness for the Clinical Care RN role through nursing chart and recorded visit audits, competency assessments, remediation oversight and talent management. This role bridges clinical excellence with operational leadership, conducting structured audits, and driving remediation for clinical competency gaps in partnership with the Education team. You will report to the Director of Physician Strategy. Must reside in designated geographic area, in reasonable commutable distance to CenterWell/Conviva market locations; quarterly or as-needed travel within market. Role Scope Clinical Competency & Oversight: Conduct and oversee clinical competency audits for nursing staff (Clinical Care RN); support remediation in partnership with Center of Excellence leaders and Education team. Clinical Competency & Oversight tooling: Develop audit tools, processes, and remediation approaches in partnership with the Medical Director, Care Integration Team & High Risk Patient Management Program. Onboarding & Talent Management: Initial interview and assessment of Clinical Care RN candidates; maintenance of onboarding design and process adherence in partnership with Center Administrators. Duties and Responsibilities Clinical Competency & Auditing Develop and maintain clinical competency audit tools and processes aligned with organizational standards and evidence-based best practices. Conduct clinical competency audits of RN documentation, clinical decision‑making, and patient care practices; perform targeted reviews of charts and recorded successful patient contacts. Conduct regular audits on each nurse at prescribed cadence. Develop remediation approaches for nurses identified with clinical competency gaps; oversee and monitor remediation execution in collaboration with market operators and Education team. Audit rounds/huddle quality; provide coaching to nurses on case presentation skills. Nursing Staff Development & Recruitment Support onboarding processes and tools for RNs, in partnership with Stars CoE Program Leads; coordinate with Education team for onboarding activities. Develop standard job descriptions and competency frameworks for nursing roles. Create and maintain interview guides and recruitment processes; establish guardrails for opening requests (capacity, geography, leader approval). Conduct first‑round interviews for Clinical Care RN and project manage talent acquisition process. Use your skills to make an impact Required Qualifications Bachelor's Degree in Nursing (BSN). Active, unrestricted RN license. 5+ years of clinical nursing experience with transitions of care or population health management. Strong clinical judgment and ability to apply evidence-based practices. Proficiency with EMR and care management platforms (any system). Preferred Qualifications Master's degree in Nursing, Business Administration, or Healthcare Management. Knowledge of Medicare Advantage Stars, HEDIS, CAHPS, and CMS quality requirements. Experience in clinical competency assessment, audit development, or compliance oversight. Proficiency with electronic health records (Athena EMR), data analytics platforms (DataHub), and Microsoft Office Suite. Familiarity with SalesForce, Genesys, and operational platform tools. Experience recruiting, interviewing, and onboarding for clinical roles. Strong communication, presentation, and stakeholder engagement skills. Commitment to health equity, inclusivity, and patient-centered care. Basic Life Support (BLS) certification. Working Conditions Workstyle: Hybrid Location: Must reside in designated geographic area, in reasonable commutable distance to market clinics; quarterly or as-needed travel within market. Hours: Monday–Friday, 8:00 AM–5:00 PM; additional time may be required for program improvement projects or strategic initiatives. 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 required; 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. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours: 40 Pay Range 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. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 – $107,800 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers 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. 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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. Centerwell, a wholly owned subsidiary of 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. We also provide free language interpreter services. #J-18808-Ljbffr