Director, Quality Improvement

Company: Humana Inc
Location: Baton Rouge
Posted on: May 2, 2025

Job Description:

Director, Quality Improvement page is loadedDirector, Quality ImprovementApply locations: Remote, Louisiana (New Orleans, Metairie, Baton Rouge)Time type: Full timePosted on: Posted 3 Days AgoJob requisition ID: R-374772Become a part of our caring community and help us put health firstThe Director, Quality Improvement is responsible for implementing quality improvement programs across all lines of business, including developing annual program descriptions, work plans, and evaluations. This role requires a deep understanding of organizational capabilities and their interrelations within the function or segment. The Director monitors quality investigations and ensures compliance processes are followed.Role Overview:

• Manage the quality management system, department SharePoint, and reporting; conduct audits for compliance.
• Complete and submit reports to CMS and state regulators as required for clinical studies.
• Make decisions related to new or updated programs, large-scale projects, and strategic planning to drive goals and improve performance.
• Contribute to the development of departmental strategies.Use your skills to make an impactRequired Qualifications:

• Bachelor's Degree
• Louisiana-licensed registered nurse, advanced practice registered nurse, physician, physician's assistant, or willing to obtain certification within 6 months:
  • CPHQ by NAHQ or
  • CHCQM by the American Board of Quality Assurance and Utilization Review Providers
  • 5+ years of management and supervisory experience in quality
  • 5+ years in a fast-paced insurance or healthcare setting
  • 3+ years in provider relations and education
  • Understanding of healthcare quality measures (STARS, HEDIS, etc.)
  • Proficiency in Microsoft Office Suite
  • Proven analytical and communication skills
  • Strong relationship-building skills
  • Residency in Louisiana and willingness to travel up to 25%
  • Working knowledge of Value-Based ContractingPreferred Qualifications:
    • Master's Degree
    • Additional certifications in healthcare quality management (e.g., CPHQ, CHCQM)
    • Knowledge of Humana's policies and systems
    • Six Sigma or similar quality management training
    • Experience with Power BI and pivot tablesAdditional Information:
      • Work-At-Home Requirements: internet speed of at least 25 Mbps download and 10 Mbps upload; dedicated workspace; compliance with HIPAA and PHI security.
      • Interview process may include HireVue assessments.
      • Travel up to 25% for meetings and training.Compensation and Benefits:Annual salary: $126,300 - $173,700, plus bonus potential. Benefits include medical, dental, vision, 401(k), paid time off, disability, life insurance, and more.About Humana:Humana Inc. is dedicated to health first initiatives, serving diverse populations through insurance and healthcare services, aiming to improve quality of life.Equal Opportunity Employer:Humana values diversity and inclusion, ensuring non-discriminatory employment practices and affirmative action in accordance with applicable laws.
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Keywords: Humana Inc, Lafayette , Director, Quality Improvement, Executive , Baton Rouge, Louisiana