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The Senior Quality Compliance Nurse Professional is an integral part of the Ohio Quality Improvement Department. This role will collaborate with internal and external customers to complete fast-paced and time sensitive projects Responsibilities* The Senior Quality Compliance Nurse Professional will partner with The Ohio Department of Medicaid and other Managed Care Organizations to meet benchmarks, goals and deliverables for Quality Improvement clinical and non-clinical performance projects.
This role is expected to research, gather information and analyze data in an expedited timeframe and use QI tools and templates to report out in cross-functional workgroups/subgroups using the tenants of QI Science. This position will also require leading internal and external workgroups for the collaborative as directed. The Senior Quality Compliance Nurse Professional works independently, sometimes in ambiguous situations, and work may be performed with minimal direction.
The position will have additional responsibilities based on business needs.Required*.Qualifications:* + Bachelor’s degree or 4 + years of relevant experience + Must be RN in the state of Ohio with an active and unrestricted license + Knowledge of quality and process improvement approaches (PDSA, DMAIC, etc.) + Previous managed care Medicaid experience + Demonstrated management experience and ability to partner with senior leadership on strategic initiatives + Demonstrated ability to manage multiple projects and meet deadlines specifically in DMAIC and PDSA style reporting and analysis + Experience presenting information to internal and external stakeholders + Experience with Microsoft Office Suite +.
WAH requirements* : Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required +.COVID VACCINATION* : Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters.
Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field Preferred Qualifications:* + CPHQ + Six Sigma + Previous experience with QI Science and methodologies (IHI) + Project Management knowledge and skills + Proficiency in verbal and written communication to senior and executive leadership + Strong organizational skills and ability to manage multiple or competing priorities + Strong analytical and problem-solving skills.Additional information* +.
Schedule:* Monday to Friday from 8 am to 5 pm.
Open for Flexible Start and Stop times. +.Training:* Remote learning, 30-90 days self-paced and some class training +.Work Location (Address): Remote OH* +.% Travel: 20%* \\.
Scheduled Weekly Hours* 40 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 https://www.humana.com/legal/accessibility-resources’source=Humana_Website..