Senior Quality Compliance Nurse Professional

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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.