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Market Executive of Clinical Quality, Home Health

$104k - $143k

Humana Inc

Become a part of our caring community This is a remote role that requires travel to branch locations in Illinois and Indiana. You will report to the Director of Home Health Clinic Operations Strategy. This is a salaried position which includes participation in an annual incentive bonus plan of up to 25% of annual salary. The Market Executive of Clinical Quality, you will drive clinical quality and regulatory metrics by onsite leadership in assigned market. You will be accountable for the following: clinical and survey metrics, clinical operations metrics, claims denials, AO/state survey results, risk mitigation, clinical compliance, QAPI adherence and VBP performance. Work with area operations and branch leaders on processes, initiatives and in-scope changes or updates. Essential Functions Improve clinical quality and regulatory metrics in assigned branches through coaching clinical managers and staff on improving care delivery and documentation requirements. Implement and monitor clinical performance of advanced clinical care programs into assigned branches. Monitor quality metrics for assigned Market; report main insights to AVP of Ops & Area Exec of Clinical Quality and other important Clinical/Ops partners. Conduct survey audits to prepare for official surveys and support locations through survey process. Conduct meaningful virtual/in-person branch interactions to improve performance. Use your skills to make an impact Knowledge/Skills/Expectations You will be located in either Illinois or Indiana (or surrounding area). Knowledge of business management and government regulations; expertise in relevant state regulations and survey activities. Analyze medical documents, financial reports and legal documents. Coach/mentor branch leadership and clinicians to influence changes in daily clinical activities. Proactively engage to identify and address issues. Expertise in branch-level clinical workflows and organization structure. Analyze clinical data to drive important insights and opportunities. Possess strong judgement on workflow and process improvement. Influence and communicate. Strong execution capabilities. 60-90 branch in person touchpoints per year. Travel approximately 50%-75%. Required Qualifications Bachelor's Degree in Nursing (BSN) RN licensure in Indiana or Illinois or applicable nursing compact license. Experience with clinical quality improvement and survey preparation. Preferred Qualifications Five years of branch leadership (previous Branch Director/Regional Administrator with multi-site experience). HomeCare HomeBase (HCHB) experience. OASIS experience. Experience managing healthcare revenue. 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. $104,000 - $143,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of 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. About us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech‑language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high‑quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior‑focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com. 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. See our full accessibility rights information and language options #J-18808-Ljbffr Humana Inc

Vacancy posted 2 days ago
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