RN Risk & Quality Auditor | Power BI-Driven UM
Job in
Rochester, Monroe County, New York, 14602, USA
Listed on 2026-07-14
Listing for:
Humana Inc
Full Time
position Listed on 2026-07-14
Job specializations:
-
Quality Assurance - QA/QC
Job Description & How to Apply Below
Humana Inc. invites a Risk Management Professional 2 to lead quality audits within the Center Well Utilization Management program, focusing on CMS and NCQA standards.
The role emphasizes audit accuracy, data analysis, and risk trend identification, with dashboards built in Power BI and workflows via Power Apps. The ideal candidate is an RN with deep clinical criteria knowledge, capable of translating findings into actionable insights for leadership, and supporting regulatory audits from a
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