Remote RN: Risk & Quality Auditor, UM; Power BI
Remote / Online - Candidates ideally in
Madison, Dane County, Wisconsin, 53774, USA
Listed on 2026-07-14
Madison, Dane County, Wisconsin, 53774, USA
Listing for:
Humana Inc
Remote/Work from Home
position Listed on 2026-07-14
Job specializations:
-
Quality Assurance - QA/QC
Job Description & How to Apply Below
Humana Inc is seeking a Risk Management Professional 2 to lead quality audits within the Center Well Utilization Management program. The role emphasizes audit accuracy, data analysis, and risk trend identification, leveraging Power BI and Power Apps to support auditing, reporting and performance monitoring.
The successful candidate will have deep expertise in clinical criteria and regulatory guidance (Medicare Manuals, NCDs, LCDs, MCG) with a strong focus on quality improvement.
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