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Clinical Competency & Quality Nurse

Remote / Online - Candidates ideally in
Juneau, Juneau Borough, Alaska, 99812, USA
Listing for: Humana Inc
Full Time, Remote/Work from Home position
Listed on 2026-05-31
Job specializations:
  • Nursing
    Healthcare Nursing, Clinical Nurse Specialist
Salary/Wage Range or Industry Benchmark: 78400 - 107800 USD Yearly USD 78400.00 107800.00 YEAR
Job Description & How to Apply Below

Job Summary

The Care Integration Clinical Competency & Quality Nurse is a Center of Excellence (CoE) position responsible for ensuring the clinical quality and provider & patient engagement effectiveness for the Clinical Care RN role through nursing chart and recorded visit audits, competency assessments, remediation oversight and talent management. This role bridges clinical excellence with operational leadership, conducting structured audits, and driving remediation for clinical competency gaps in partnership with the Education team.

You will report to the Director of Physician Strategy.

Must reside in designated geographic area, in reasonable commutable distance to Center Well/Conviva market locations; quarterly or as-needed travel within market.

Role Scope

Clinical Competency & Oversight: Conduct and oversee clinical competency audits for nursing staff (Clinical Care RN); support remediation in partnership with Center of Excellence leaders and Education team.

Clinical Competency & Oversight tooling: Develop audit tools, processes, and remediation approaches in partnership with the Medical Director, Care Integration Team & High Risk Patient Management Program.

Onboarding & Talent Management: Initial interview and assessment of Clinical Care RN candidates; maintenance of onboarding design and process adherence in partnership with Center Administrators.

Duties and Responsibilities

Clinical Competency & Auditing

  • Develop and maintain clinical competency audit tools and processes aligned with organizational standards and evidence-based best practices.
  • Conduct clinical competency audits of RN documentation, clinical decision‑making, and patient care practices; perform targeted reviews of charts and recorded successful patient contacts.
  • Conduct regular audits on each nurse at prescribed cadence.
  • Develop remediation approaches for nurses identified with clinical competency gaps; oversee and monitor remediation execution in collaboration with market operators and Education team.
  • Audit rounds/huddle quality; provide coaching to nurses on case presentation skills.

Nursing Staff Development & Recruitment

  • Support onboarding processes and tools for RNs, in partnership with Stars CoE Program Leads; coordinate with Education team for onboarding activities.
  • Develop standard job descriptions and competency frameworks for nursing roles.
  • Create and maintain interview guides and recruitment processes; establish guardrails for opening requests (capacity, geography, leader approval).
  • Conduct first‑round interviews for Clinical Care RN and project manage talent acquisition process.
Use your skills to make an impact

Required Qualifications

  • Bachelor's Degree in Nursing (BSN).
  • Active, unrestricted RN license.
  • 5+ years of clinical nursing experience with transitions of care or population health management.
  • Strong clinical judgment and ability to apply evidence-based practices.
  • Proficiency with EMR and care management platforms (any system).

Preferred Qualifications

  • Master's degree in Nursing, Business Administration, or Healthcare Management.
  • Knowledge of Medicare Advantage Stars, HEDIS, CAHPS, and CMS quality requirements.
  • Experience in clinical competency assessment, audit development, or compliance oversight.
  • Proficiency with electronic health records (Athena EMR), data analytics platforms (Data Hub), and Microsoft Office Suite.
  • Familiarity with Sales Force, Genesys, and operational platform tools.
  • Experience recruiting, interviewing, and onboarding for clinical roles.
  • Strong communication, presentation, and stakeholder engagement skills.
  • Commitment to health equity, inclusivity, and patient-centered care.
  • Basic Life Support (BLS) certification.
Working Conditions

Workstyle: Hybrid

Location: Must reside in designated geographic area, in reasonable commutable distance to market clinics; quarterly or as-needed travel within market.

Hours: Monday–Friday, 8:00 AM–5:00 PM; additional time may be required for program improvement projects or strategic initiatives.

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…

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