**Become a part of our caring community and help us put health first** The Quality Improvement Director provides strategic leadership for Humana’s Michigan Medicaid Quality Improvement Program, in alignment with organizational quality and population health goals and ensuring compliance with all Contract, State, and federal requirements. The individual in this role supports NCQA accreditation and serves as the local health plan lead for accreditation compliance. The Quality Improvement Director oversees all aspects of the plan's Quality Assurance and Performance Improvement (QAPI) Program. This individual has primary responsibility to operate a quality improvement infrastructure that promotes safety, quality of care, addresses health disparities, is culturally competent, and ensures cost effective access to care in the safest, least restrictive setting. This role requires commitment to cross-functional collaboration that drives continuous quality improvement throughout health plan operations, Provider network, and community partnerships to achieve our quality improvement goals and objectives. + Provides oversight of the Quality Assurance and Performance Improvement Program, including supporting documentation such as the Quality Improvement Plan, Annual Evaluation of the QAPI Program, and the annual QAPI work plan. + Operates an NCQA compliant quality program. + Oversee the development, implementation, and management of quality improvement projects, including all required Performance Improvement Projects. + Works collaboratively with the Michigan Department of Health and Human Services (MDHHS) others to improve population health outcomes, including addressing health equity and health related social needs (HRSNs). + Partners with clinical and health equity leadership to develop a population health strategy, design innovative programs, and reduce health disparities. + Oversee HEDIS, CAHPS, and MDHHS required measure reporting and evaluation. + Ensures compliance with quality-of-care investigations and reporting. + Improves quality measure performance through innovative approaches in engaging Enrollees and Providers. + Analyzes dashboards consisting of Key Performance Indicators (KPI), and non-KPI metrics, interpreting trends and significant variances as opportunities to improve outcomes. + Incorporates actionable analytics, utilizing business intelligence tools, care coordination tools, and claims systems to identify issues, mitigate risks, and develop solutions. + Serves on the Quality Committee as required by the State. + Maintains confidential information in accordance with policies, and State and federal laws, rules and regulations regarding confidentiality. **Use your skills to make an impact** **Required Qualifications** + **Must reside in or be willing to relocate to the state of Michigan.** + Bachelor’s degree in nursing, education, public health, health administration, health policy, business or a related field. + Minimum five (5) years of experience in Quality Improvement/Quality Assurance in the healthcare field. + Minimum three (3) years of leadership experience. + Clinical program development and implementation experience. + Strong understanding across applicable NCQA accreditation standards and requirements. + Demonstrated skills in quality improvement concepts, healthcare data analysis, data mining methods and the identification of population health issues, trends, and health disparities using healthcare data sources. + Understanding of value-based payment models that reward quality improvement. + Understanding of cultural factors that influence health outcomes and implementing culturally competent improvement interventions. + Experience implementing rapid-cycle improvement techniques that demonstrated material improvements. + Excellent communication skills and experience in cross-functional collaboration in matrixed organizations. **Preferred Qualifications** + Master’s Degree. + CPHQ (Certified Professional in Healthcare Quality) Certification. + Registered nurse (RN), physician or physician’s assistant licensed in the State of Michigan without restrictions. **Additional Information** + **Workstyle:** This position's workstyle may begin as Remote but once a new Humana office is established in Detroit, MI or in a surrounding area, the workstyle will change to Hybrid Home. + **Travel:** Up to 25 % to MDHSS, throughout Michigan, team engagement meetings and conferences in and out of Michigan. + **Direct Reports:** Up to5 associates. **WAH Internet Statement** 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 connection is suggested. + Satellite, cellular and microwave connection 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. + Humana 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. **Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana'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 base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $126,300 - $173,700 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** Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) 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 outside of work. Among our benefits, Humana 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** 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. ​ **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana 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 base all employment decisions only on valid job requirements. This policy shall apply to all 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 all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.