Humana Finance/FinTech

Senior Quality Improvement Professional

Remote Full-time

Location: Remote South Carolina

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The Senior Quality Improvement Professional leads provider-focused, cross-functional initiatives to improve clinical quality, provider performance, and member experience for the Humana Healthy Horizons in South Carolina Medicaid Plan. You will develop and implement cross-functional quality improvement initiatives, evaluate business processes and performance outcomes, and drive sustainable, measurable improvements.

Reporting to the Quality Improvement Director, you will collaborate with internal and external stakeholders to advance a provider-focused culture of quality and performance excellence. You will manage complex projects and analyze diverse data sources to identify opportunities, inform strategy, and support organizational objectives.

The Senior Quality Improvement Professional leverages data to lead quality improvement initiatives, monitor performance metrics, and support provider performance enhancement. This role collaborates with provider-facing teams to implement targeted interventions, develop educational resources, and drive achievement of quality and member experience goals. The position leads and participates in multidisciplinary committees, provides strategic clinical guidance on quality initiatives, and influences business decisions through data-driven insights.

Operating with a high degree of independence, the Senior Quality Improvement Professional manages complex projects, exercises sound judgment, and recommends solutions to advance organizational objectives.

Job description provided by Humana.
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