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Quality Compliance Professional

Humana -
Oklahoma City, OK

Apply Now

Job Details

Full-time
$71,100 - $97,800 a year

Benefits

Paid parental leave
Caregiver leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Work from home
Parental leave
Vision insurance
Volunteer time off
Life insurance

Qualifications

Nursing
Quality control experience within healthcare industry
RN License
Bachelor's degree
Productivity software
Healthcare compliance
Nursing
Quality assurance experience within healthcare

Full Job Description

Become a part of our caring community

The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Quality Compliance Professional 2 completes medical records reviews for Coordination of Care studies. Analyze data and implement corrective actions as needed. Review medical records for supplemental data and enter data in supplemental data base. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Follows established guidelines/procedures.

Use your skills to make an impact

REQUIRED QUALIFICATIONS

Must reside in Oklahoma
Bachelor's degree
Registered Nurse (RN) license
2+ years clinical background
Prior experience in quality compliance in a healthcare setting
Strong oral / written communication
Comprehensive knowledge of Microsoft Office

PREFERRED QUALIFICATIONS

Knowledge of HEDIS/Stars/CMS/Quality
Previous quality or process improvement experience in healthcare
Detail orientated and comfortable working with tight deadlines

Additional Information

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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

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.

$71,100 - $97,800 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

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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.

Apply Now

Refine Your Search

healthcare compliance jobs in oklahoma

Quality Compliance Professional

Compliance Program Manager (Government-Managed Healthcare Regulations)

PACE Quality and Compliance Specialist

Director of Compliance and Risk Management

Compliance Improvement Manager

Coding Data Quality Auditor

Internal Auditor (Information Technology, Accounting, Clinical)

Senior Billing Compliance Analyst

Associate General Counsel (or Senior Associate General Counsel)

National Nurse Compliance Surveyors - Home Health or Hospice

Coding Auditor

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