Senior Quality Assurance, Clinical Professional

Become a part of our caring community Shift/Availability Requirements This position is full time 40 hours a week, scheduled for 8 hour shifts, 5 days a week. The schedule is Monday-Friday from 9am-5:30pm EST. As the Senior Quality Assurance, Clinical Professional , you will report directly to the Manager, Care Management. You will complete Quality audits of patient interactions to maintain quality standards of existing products and services, and collaborate to develop programs to focus employees on the quality of care given to patients. Responsibilities Collaborate with leadership to develop policies, procedures and methods to check operational quality and improve same. Identify areas of opportunities and elevate to leadership in areas such as quality improvement, process management and reliability science. Maintain communications with leadership regarding quality assurance activities. Begin to influence department's strategy. Make decisions on moderately complex to complex issues regarding technical approach for project components, and perform work without direction. Work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Exercise considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Experience/Skills Current and unrestricted Registered Nurse licensure. 2 or more years of experience working with a Quality Assurance program. 2 or more years of Home Health or Care Management experience. Comprehensive knowledge of Microsoft Office applications, including Outlook, Word, Excel, PowerPoint and Teams. Proficiency in analyzing and interpreting data trends. Experience completing efficient health-related research, with associated analysis and conclusions and contributing to development of policies, procedures and methods to check operational quality and improve same. Experience collaborating with management in areas such as quality improvement, process management and reliability science. Can make decisions on moderately complex to complex issues regarding technical approach for project components. Strong organizational and communication skills (written and verbal). Must be passionate about contributing to an organization focused on improving consumer experiences. Remote Internet Requirements 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. Home or Hybrid Home/Office employees will be provided 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. $86,300 - $118,700 per year 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. 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