IACG Quality Assurance 2-1

Profile

Description

The Internal Audit Consulting Group (IACG) Quality Assurance Professional 2 develops, plans and evaluates internal audit programs for the organization's clinical business areas and related procedures to ensure compliance with the organization's policies, procedures and standards. The IACG Quality Assurance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate court of action.

Responsibilities

The IACG Quality Assurance Professional 2 audits clinical areas, processes, and applications to ensure that appropriate controls exist to minimize clinical risks. Applies clinical knowledge and experience to areas of review. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.

Detailed role responsibilities include but are not limited to:


Connect with leaders in business segments, foster relationships leading to greater collaboration.
Identify areas of clinical concern and possible risks.
Collaborate with inter-departmental contacts, discussing emerging risks, aligning on areas of focus and timing.
Develop and execute specific testing or audit plans related to clinical risks.
Educate on need for clinical involvement in process decisions.
Promote culture of continuous improvement.


Required Qualifications


Bachelor's or Associate's degree
3-5 or more years of clinical nursing experience
Active Registered Nurse (RN) license with no disciplinary action
Strong analytical and problem solving skills
Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint


Preferred Qualifications


AAPC or AHIMA Coding Certification
Experience in managed care or health care administration desired
Experience with utilization review process


Additional Information

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from **** with instructions to add the information into the application at Humana's secure website.

Scheduled Weekly Hours

40

Company info

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