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Humana
Quality Assurance Professional
Remote · United States · Full time · Mid level
$65k–$88.6k / year
About the role
Review LTSS contractor documentation and performance for compliance with regulations. Ensure adherence to policies and prevent fraud, waste, and abuse.
What you’ll do
• Conduct and summarize compliance audits and reports. • Collect and analyze records and data regularly. • Perform inter-rater reliability audits for vendor activities. • Ensure adherence to MDHHS, NCQA, CMS, and Humana policies. • Communicate audit results timely with leadership.
What you’ll bring
• Reside in Michigan or within 40 miles of border. • Bachelor's degree required. • 2+ years in care management or quality assurance. • Experience with Managed Care Organization. • Proficient in Microsoft Office products.
Life at Humana
Humana offers competitive benefits including medical, dental, vision, 401(k), paid time off, parental leave, disability, and life insurance. Supports whole-person well-being.
About Humana
Humana Inc. is a leading U.S. healthcare company providing insurance and healthcare services to improve quality of life for Medicare, Medicaid, and other populations.