Quality Compliance Professional

Job Responsibilities

• Complete annual quality reviews and research.
• Perform varied assignments requiring independent determination of appropriate courses of action.
• Conduct medical record reviews for Coordination of Care studies.
• Analyze data and implement corrective actions as needed.
• Review medical records for supplemental data and enter data into the supplemental database.
• Interpret established guidelines and procedures, aligning departmental and organizational objectives.

• Must reside in Oklahoma.
• Bachelor’s degree.
• Registered Nurse (RN) license.
• Minimum 2 years of clinical experience.
• Prior experience in quality compliance within a healthcare setting.
• Strong oral and written communication skills.
• Comprehensive knowledge of Microsoft Office.

• Knowledge of HEDIS, Stars, CMS, or other quality metrics.
• Previous quality or process improvement experience in healthcare.
• Detail‑oriented and comfortable working with tight deadlines.

Work can be performed from home or a hybrid location. Employees must provide reliable internet service meeting at least 25

Mbps download and 10

Mbps upload speeds. If working from home in California, Illinois, Montana, or South Dakota, a bi‑weekly payment will be provided for approved internet expenses. Telephone equipment will be supplied as needed.

Occasional travel to company offices for training or meetings may be required.

$71,100 – $97,800 per year (based on geographic location and experience). This role is eligible for a bonus incentive plan.

• Medical, dental, and vision coverage.
• 401(k) retirement savings plan.
• Paid time off, holidays, volunteer time off, and paid parental and caregiver leave.
• Short‑term and long‑term disability coverage.
• Life insurance.

Humana is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status. We also provide affirmative action and are committed to hiring individuals with disabilities or protected veteran status, basing all employment decisions on valid job requirements.