Clinical Quality Compliance Specialist- (NCQA accreditation, CMS Medicare and Medicaid Plan, HEDIS and STARS)
Location: Bridgeport Connecticut
Description: Humana is in need of Clinical Quality Compliance Specialist- (NCQA accreditation, CMS Medicare and Medicaid Plan, HEDIS and STARS) right now, this vacancy will be placed in Connecticut. Detailed specification about this vacancy opportunity kindly read the description below. As a
Clinical QA and C! ompliance Specialist
you will prepare c
linical quality reporting and documentation, reports and materials to meet NCQA accreditation, State and Federal regulatory and clinical quality requirements for Humana Chronic Care Program (HCCP), SNP (Special Needs Plan), and/or Medicare Medicaid Integration Plan (MMP) care management programs.
You will work with internal and external stakeholders to deliver Humana Cares quality and compliance program requirements.
Key Competencies
Builds Trust: You honor your word by doing what you say you are going to do.
Drives for excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition.
Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools to meet internal and extern! al deadlines. You can apply critical thinking to complex compl! iance requirements, and create timely and accurate submissions.
Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
Qualifications
Role Essentials
Bachelor's Degree in a health-related field.
Knowledge and technical proficiency with Microsoft Office applications to include Word, Excel, Visio, and PowerPoint.
Understanding of Quality Improvement principles
Group facilitation and presentation skills
Excellent written communication skills
Prior data analysis experience.
Role Desirables
Master’s Degree in Nursing or a related field preferred
Experience with quality reporting and compliance submissions, including NCQA accreditation, SNP Structure and Process, CMS Medicare and Medicaid Pla! n Quality, HEDIS and STARS.
Familiarity with Humana’s operating systems.
Reporting Relationships
·
You will report to a Quality Compliance Manager. This area is under the leadership of the Director of Clinical Innovations
Schedule
:
Full-time
Primary Location
:
US-Connecticut-Bridgeport
Role
:
Clinical Innovations and Health Practitioners
Work Environment Type
:
Office, Virtual/Work At Home
Travel
:
Yes, 5 % of the Time
- .
If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Humana.
If you interested on this vacancy just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Sat, 27 Jul 2013 19:44:50 GMT