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 8hour shifts,5days a week.

• The schedule isMonday-Friday from9am-5:30pmEST.

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.

As the Senior Quality Assurance, Clinical Professional you will:

• Collaborate with leadership to develop policies, procedures and methods to check operational quality and improve same.

• Identify areas of opportunities and escalate 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.

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.

• 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.

Scheduled Weekly Hours

Pay Range

Description of Benefits

About us

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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.