Quality Compliance Professional
Location
United States
Posted
2 days ago
Salary
$71.1K - $97.8K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Quality Compliance Professional
Humana
Role Description 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. - Completes medical records reviews for Coordination of Care studies. - Analyzes data and implements corrective actions as needed. - Reviews medical records for supplemental data and enters data in supplemental database. - Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. - Follows established guidelines/procedures. 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 Requirements - Knowledge of HEDIS/Stars/CMS/Quality - Previous quality or process improvement experience in healthcare - Detail oriented and comfortable working with tight deadlines Benefits - 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 - Many other opportunities 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. $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.
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