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The Senior Quality Compliance Nurse Professional is an integral part of the Oklahoma Quality Improvement Department. This role will collaborate with internal and external customers to meet benchmarks, goals and complete time sensitive deliverables for Quality Improvement clinical and non-clinical performance projects. The role operates as a subject matter expert in Quality Compliance.
The Senior Quality Compliance Nurse Professional makes decisions on moderately complex to complex issues regarding technical approach for project components, works independently, sometimes in ambiguous situations and work may be performed with minimal direction to ensure the highest accountability of compliance and quality.
This position will be involved in studies as required by the External Quality Review Organization or the State and monitors activities and performance metrics for the Oklahoma Medicaid program. The Senior Quality Compliance Nurse Professional exercises considerable latitude in determining objectives and approaches to assignments, with work that influences the quality department and the Oklahoma Medicaid strategy.
This role will completes data analysis and implement quality improvement programs as needed. Decisions would be related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
Success in this role will require departmental and managed care collaboration, .
May participate in multidisciplinary committees, both external and internal and conduct briefings and area meetings.
*Required Qualifications*
* RN License for State of OK required, unrestricted
* Bachelor's degree or 4+ years relevant work experience in healthcare settings
* Knowledge of quality and process improvement approaches (PDSA, DMAIC, etc.)
* Experience presenting information to internal and/or external stakeholders
* Demonstrated ability to partner with senior leadership on strategic initiatives
* Comprehensive knowledge of Microsoft Word, Excel and PowerPoint.
* *Must reside in the state of Oklahoma.*
*Preferred Qualifications*
* *Experience with Medicaid programs* *strongly preferred.*
* *Previous experience with QI Science and methodologies (IHI).*
* Certified Professional in Healthcare Quality (CPHQ)
* Project Management skills
* Proficiency in verbal and written communication to senior and executive leadership
* Strong organizational skills and ability to manage multiple or competing priorities.
*Additional Information*
*Workstyle: *Hybrid; A combination of remote and Humana's Oklahoma City location.
Job Type: Full-time
Pay: $36.92 - $48.07 per hour
Expected hours: No less than 40 per week
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Employee assistance program
* Employee discount
* Flexible spending account
* Health insurance
* Health savings account
* Life insurance
* Paid time off
* Parental leave
* Professional development assistance
* Retirement plan
* Tuition reimbursement
* Vision insurance
Schedule:
* 8 hour shift
* Monday to Friday
Supplemental pay types:
* Bonus opportunities
Application Question(s):
* Do you have a minimum of a Bachelor's degree or 4+ years relevant work experience in healthcare settings
Education:
* Bachelor's (Preferred)
Experience:
* Quality and Process Improvement: 4 years (Required)
License/Certification:
* RN License for State of OK (Required)
Ability to Commute:
* 28th Floor .Oklahoma City, OK 73102 (Required)
Work Location: Hybrid remote in 28th Floor .Oklahoma City, OK 73102
The Senior Quality Compliance Nurse Professional makes decisions on moderately complex to complex issues regarding technical approach for project components, works independently, sometimes in ambiguous situations and work may be performed with minimal direction to ensure the highest accountability of compliance and quality.
This position will be involved in studies as required by the External Quality Review Organization or the State and monitors activities and performance metrics for the Oklahoma Medicaid program. The Senior Quality Compliance Nurse Professional exercises considerable latitude in determining objectives and approaches to assignments, with work that influences the quality department and the Oklahoma Medicaid strategy.
This role will completes data analysis and implement quality improvement programs as needed. Decisions would be related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
Success in this role will require departmental and managed care collaboration, .
May participate in multidisciplinary committees, both external and internal and conduct briefings and area meetings.
*Required Qualifications*
* RN License for State of OK required, unrestricted
* Bachelor's degree or 4+ years relevant work experience in healthcare settings
* Knowledge of quality and process improvement approaches (PDSA, DMAIC, etc.)
* Experience presenting information to internal and/or external stakeholders
* Demonstrated ability to partner with senior leadership on strategic initiatives
* Comprehensive knowledge of Microsoft Word, Excel and PowerPoint.
* *Must reside in the state of Oklahoma.*
*Preferred Qualifications*
* *Experience with Medicaid programs* *strongly preferred.*
* *Previous experience with QI Science and methodologies (IHI).*
* Certified Professional in Healthcare Quality (CPHQ)
* Project Management skills
* Proficiency in verbal and written communication to senior and executive leadership
* Strong organizational skills and ability to manage multiple or competing priorities.
*Additional Information*
*Workstyle: *Hybrid; A combination of remote and Humana's Oklahoma City location.
Job Type: Full-time
Pay: $36.92 - $48.07 per hour
Expected hours: No less than 40 per week
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Employee assistance program
* Employee discount
* Flexible spending account
* Health insurance
* Health savings account
* Life insurance
* Paid time off
* Parental leave
* Professional development assistance
* Retirement plan
* Tuition reimbursement
* Vision insurance
Schedule:
* 8 hour shift
* Monday to Friday
Supplemental pay types:
* Bonus opportunities
Application Question(s):
* Do you have a minimum of a Bachelor's degree or 4+ years relevant work experience in healthcare settings
Education:
* Bachelor's (Preferred)
Experience:
* Quality and Process Improvement: 4 years (Required)
License/Certification:
* RN License for State of OK (Required)
Ability to Commute:
* 28th Floor .Oklahoma City, OK 73102 (Required)
Work Location: Hybrid remote in 28th Floor .Oklahoma City, OK 73102