Unknown Company is hiring a Manager, Quality Improvement

Humana seeks a Manager, Quality Improvement to join our team and implement effective quality improvement programs for all lines of business, with a specific focus on Humana Healthy Horizons in Oklahoma. This key role is central to NCQA Health Plan accreditation and drives quality improvement efforts across Humana's Quality Operations.

What You'll Do

• Implement quality improvement programs for all lines of business, including the annual program description, work plan, and evaluation.
• Ensure the Quality Assessment and Performance Improvement (QAPI) program for Humana Healthy Horizons in Oklahoma operates effectively.
• Drive quality improvement efforts for Humana’s Quality Operations.
• Support the implementation and monitoring of program documents such as the program description, work plan, QAPI committee evaluation, and other quality operations functions.
• Audit processes as needed for compliance.
• Complete and submit required state or federal reports.
• Collaborate and maintain frequent contact with other managers across departments and the health plan.
• Conduct briefings and area meetings.
• Determine the plan’s compliance with NCQA accreditation requirements.
• Track HEDIS measures with assistance from the Quality Data Analyst to ensure the plan meets goals for quality measure withholds.
• Coordinate with internal/external stakeholders, providers, the state department of health, and other entities to maintain quality operations and improve health outcomes.

What We're Looking For

• Must reside in the state of Oklahoma.
• Bachelor's degree required.
• 2+ years of management or leadership experience.
• 2+ years of experience in a fast-paced insurance or healthcare setting.
• Familiarity with Quality Improvement tools and methodologies (e.g., PDSA, root cause analysis, IHI Model for Improvement).
• Understanding of healthcare quality measures such as HEDIS, STARS, etc.
• Demonstrated ability to build and maintain strong professional relationships.
• Proficient in Microsoft Office Suite, including Word, Excel, and PowerPoint.
• Strong analytical and problem-solving skills.
• Excellent verbal and written communication skills.

Nice to Have

• Experience working with Performance Improvement Projects (PIPs).
• CPHQ (Certified Professional in Healthcare Quality).
• Prior experience with Medicaid programs.

Technical Stack

• Microsoft Office Suite (Word, Excel, PowerPoint)

Team & Environment

You will collaborate and maintain frequent contact with other managers across departments and the health plan.

Benefits & Compensation

• Compensation: $86,300 - $118,700 per year
• 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

Work Mode

This is a hybrid position based in Oklahoma.

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.