Senior Quality Improvement Professional - EPSDT - Office / Remote KY IN OH

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Job Information
Humana
Senior Quality Improvement Professional - EPSDT - Office / Remote KY, IN, OH
in
Indianapolis
Indiana
Description
The Senior Quality Improvement Professional-EPSDT (Early Periodic Screening Diagnosis and Treatment) uses quality improvement methodology to assess, implement, and evaluate activities to monitor EPSDT program quality and continuously improve performance measures (HEDIS, CAHPS, state specific outcomes) for Kentucky Medicaid enrollees.
Responsibilities
The Senior Quality Improvement Professional-EPSDT provides oversight of EPSDT outreach calls and data analysis to identify new creative interventions to increase EPSDT screening and adoption of Special Services.
Role Overview:
Frequently performs data interpretation, independently determine an appropriate course of action, and present these ideas/plans to governance teams/committees.
The role includes creating and maintaining partnerships with state and community stakeholders.
Work is guided by contractual, accreditation, and CMS requirements.
Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
Follows established guidelines/procedures.
Has proven data analysis skills, quality improvement project management skills, and a strong knowledge of EPSDT federal requirements.
This is a Hybrid Role where you will be required to work 3 days in the office and 2 days in your home office
Required Qualifications
Bachelor's degree in nursing, healthcare, or related field
Prior experience in a fast paced insurance or health care setting
Knowledge of EPSDT requirements
3 years' experience working on healthcare quality and performance measure improvement activities (example HEDIS, CAHPS)
Comprehensive knowledge of Microsoft Office Word, PowerPoint, Excel
Must reside in KY, IN, OH within driving distance of Louisville, KY to work in the office 3 days a week and to attend meetings (see additional information below)
Must be available to travel to attend the State meetings (to be discussed during interview)
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination or commit to testing protocols OR  
Provide proof of applicable exemption including any required supporting documentation
Medical, religious, state and remote-only work exemptions are available.
Work At Home Requirements
Must have a separate room with a locked door that can be used as a home office to ensure you and your members have absolute and continuous privacy while you work.
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 10x1 (10mbs download x 1mbs upload) is required.
Preferred Qualifications
Active Kentucky licensed clinician including: Pharmacist, Registered Nurse, other licensed healthcare professional
Current experience working with a complex Medicaid population
Experience using quality improvement methodology such as plan-do-study-act
Project management experience
Knowledge of Humana's internal policies, procedures and systems
Experience developing provider facing educational materials
Detail orientated and comfortable working with tight deadlines in a fast paced environment
Additional Information
Onsite Travel
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.
#ThriveTogether #WorkAtHome
Interview Format
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Modern Hire Voice 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.
If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed)
inviting you to participate in a Modern Hire Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews
Scheduled Weekly Hours
40

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