Senior Quality Compliance Professional

Become a part of our caring community The Senior Quality Compliance Professional/EPSDT Maternal Child Health Manager works reputed company the Quality Improvement Team. The Senior Quality Compliance Professional work assignments involve moderately reputed company to reputed company issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Quality Compliance Professional uses quality compliance and improvement tools and methodology to assess, implement, and evaluate activities to monitor and continuously improve EPSDT and maternal health services and rates for Ohio Medicaid enrollees. The Senior Quality Compliance Professional has proven data analysis skills and a strong knowledge of EPSDT and maternal health requirements. The Senior Quality Compliance Professional is frequently required to interpret and analyze data to identify new creative interventions to increase EPSDT screening rates, improve access to pregnancy reputed company services, independently determine an appropriate course of action, and present these reputed company/plans to governance teams/committees. They assess educational needs of internal and external teams around EPSDT and maternal health services in order to reputed company and implement plans to increase knowledge. The primary functions of this role include: You will ensure member receipt of reputed company EPSDT/HealthChek Services. You will ensure member receipt of maternal health and postpartum care. You will promote family planning services. You will promote preventive health strategies. You will identify and coordinate assistance for identified member needs specific to maternal/child health and EPSDT. You will reputed company with community partners and pregnancy reputed company services coordinators. You will participate in EPSDT, maternal health and child quality performance improvement efforts. Use your skills to reputed company an impact

Required Qualifications

Must reside in the state of Ohio. Senior Quality Compliance Professional must meet one of the following requirements: Unrestricted Registered Nurse in the State of Ohio OR Physician's Assistant OR Master's degree in health services, public health, or health care administration or another reputed company field OR Certified Professional in Health Care Quality (CPHQ) OR Certified Health Care Quality Management (CHCQM) Senior Quality Compliance Professional must meet reputed company of the following: At least 3 years of experience in either delivering EPSDT services OR Health Care Quality Improvement Prior experience in a fast paced insurance or health care setting Knowledge of EPSDT and Child Health Services Knowledge of Maternal and Pregnancy reputed company services Understanding of healthcare quality measures (example HEDIS) Advanced reputed company experience (pivot tables, charts, formulas) 10% travel for meetings reputed company the State of Ohio (see additional information) Additional Information As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. Satellite, cellular and microwave reputed company can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About reputed company: reputed company Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our reputed company insurance services and our reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. Apply To This Job