Manager, Quality Assurance (Medicaid)
Welcome to Humana, a leading healthcare company committed to helping our members achieve their best health. We are currently seeking a highly skilled and experienced Manager of Quality Assurance to join our Medicaid team. In this role, you will play a crucial role in ensuring that our Medicaid programs meet and exceed quality standards, ultimately improving the health outcomes of our members. If you are a dedicated leader with a passion for quality and a strong understanding of the Medicaid landscape, we encourage you to apply for this exciting opportunity.
- Develop and implement quality assurance procedures and protocols for Humana's Medicaid programs.
- Oversee and manage a team of quality assurance professionals, providing guidance and support to ensure standards are met.
- Conduct regular audits and reviews to assess the effectiveness of current quality processes and identify areas for improvement.
- Work closely with cross-functional teams to ensure quality standards are integrated into all aspects of Medicaid program development and operations.
- Collaborate with leadership to establish and track key performance indicators (KPIs) related to quality and report findings to senior management.
- Stay up-to-date on industry regulations and best practices related to Medicaid quality assurance and ensure compliance within Humana's programs.
- Develop and maintain relationships with external stakeholders, such as government agencies and healthcare providers, to promote quality improvements.
- Analyze data and trends to identify potential areas of risk and recommend proactive solutions.
- Lead training and development initiatives to ensure all team members are knowledgeable about quality standards and procedures.
- Serve as a subject matter expert on quality assurance in the Medicaid landscape, providing insights and recommendations to inform decision-making processes.
Bachelor's Degree In A Relevant Field Such As Healthcare Administration, Quality Management, Or Public Health.
Minimum Of 3-5 Years Of Experience In Quality Assurance, Preferably In A Medicaid Or Managed Care Setting.
Strong Understanding Of Medicaid Regulations And Guidelines, Including Cms Requirements.
Excellent Leadership And Communication Skills, With The Ability To Effectively Manage A Team And Collaborate With Cross-Functional Departments.
Experience With Quality Improvement Methodologies And Tools, Such As Lean Six Sigma, And A Track Record Of Successfully Implementing Quality Initiatives.
Quality Assurance
Process Improvement
Data Analysis
Performance metrics
Team Leadership
Compliance Management
Risk assessment
Audit management
Training and Development
Policy Development
Budget
Medicaid Regulations
Communication
Emotional Intelligence
Leadership
Time management
Interpersonal Skills
creativity
flexibility
Teamwork
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a Manager, Quality Assurance (Medicaid) in Michigan, USA is $84,000 - $117,000 per year. This may vary depending on factors such as the size of the company, location, and level of experience.
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Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.
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