Become a part of our caring community and help us put health first
 

The Senior Quality Compliance Nurse Professional is an integral part of the Oklahoma Quality Improvement Department. This role will collaborate with internal and external customers to meet benchmarks, goals and complete time sensitive deliverables for Quality Improvement clinical and non-clinical performance projects. The role operates as a subject matter expert in Quality Compliance.

The Senior Quality Compliance Nurse Professional makes decisions on moderately complex to complex issues regarding technical approach for project components, works independently, sometimes in ambiguous situations and work may be performed with minimal direction to ensure the highest accountability of compliance and quality.

This position will be involved in studies as required by the External Quality Review Organization or the State and monitors activities and performance metrics for the Oklahoma Medicaid program. The Senior Quality Compliance Nurse Professional exercises considerable latitude in determining objectives and approaches to assignments, with work that influences the quality department and the Oklahoma Medicaid strategy.

This role will completes data analysis and implement quality improvement programs as needed. Decisions would be related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.

Success in this role will require departmental and managed care collaboration, .

May participate in multidisciplinary committees, both external and internal and conduct briefings and area meetings.

Use your skills to make an impact
 

Required Qualifications

• RN License for State of OK required, unrestricted
• Bachelor's degree or 4+ years relevant work experience in healthcare settings
• Knowledge of quality and process improvement approaches (PDSA, DMAIC, etc.)
• Experience presenting information to internal and/or external stakeholders
• Demonstrated ability to partner with senior leadership on strategic initiatives
• Comprehensive knowledge of Microsoft Word, Excel and PowerPoint.
• Must reside in the state of Oklahoma.

Preferred Qualifications

• Experience with Medicaid programs strongly preferred.
• Previous experience with QI Science and methodologies (IHI).
• Certified Professional in Healthcare Quality (CPHQ)
• Project Management skills
• Proficiency in verbal and written communication to senior and executive leadership
• Strong organizational skills and ability to manage multiple or competing priorities.

Workstyle: Hybrid; A combination of remote and Humana's Oklahoma City location.

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:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; 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.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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.

$76,800 – $105,800 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
 

Humana Inc. (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.

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 because he or she is a protected veteran. 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.