Supervisor, Quality Management

Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded health benefits companies, with approximately 9 million medical members. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Over its 45-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.



HMHS


Humana Military Healthcare Services is a subsidiary of Humana Inc., one of the nation's largest health insurance companies. As the TRICARE program administrator for the South Region of the United States, Humana Military provides health care benefits for more than 2.7 million of the nation's active duty and their family members, military retirees' and their family members.


The Supervisor of Quality Management (Market) supports the Regional Manager Quality Management by providing oversight and supervision of the Quality Management (QM) process at the market level, ensuring implementation of the Clinical Quality Management Program (CQMP). This person will serve as the market point of contact for any quality management issues. Oversees that clinical quality of care issues are appropriately researched, the quality database is updated and maintained, cases are ready for peer review, and corrective action plans are documented, implemented and monitored. Responsible for coordination with the Corporate Clinical Quality Management Department to ensure compliance of Quality Management Policies and Procedures. Maintains oversight of compliance issues to maintain timeliness standards. Supervises Clinical Quality Management Coordinators in the market.


Minimum Requirements

Bachelor?s Degree in healthcare discipline or Bachelor?s Degree in Nursing (RN)

Active nursing license in state of employment.

Minimum 2 years quality management experience within past 5 years

2 years supervisory experience

Certification desirable in a recognized professional UM/QM organization. (i.e., CPHQ) is desired.

Accreditation (URAC, NCQA or JCAHO) experience is desired.




Our Department of Defense contract requires U.S. citizenship for this position.