# Provider Quality Improvement Manager

**Company**: Inclusa, a Humana company
**Location**: Remote Wisconsin
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $86,300 - $118,700 per year
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Wisconsin/Manager--Provider-Quality-Improvement_R-434627-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/provider-quality-improvement-manager-f21fcf46-c72/

## Description

We are seeking a Provider Quality Improvement Manager to partner across the organization to strengthen provider quality, improve processes, and drive better outcomes. As a key member of our team, you will oversee provider surveys, audits, incident trends, regulatory follow-up, corrective actions, and quality improvement initiatives.

**Responsibilities:**

- Lead collaborative survey question development, analysis, and improvement interventions for provider surveys

- Conduct audits of provider-related activities to ensure policies and processes are followed

- Make provider quality referrals to external regulatory entities based on complaints or incident reports

- Review and follow up with providers on statements of deficiencies issued through regulatory entities

- Collaborate on provider-related activities across the organization, ensuring engagement in process improvement interventions

- Analyze and report on provider quality metrics and trends, including report out to leadership and development of the annual quality management program description, work plan, and evaluation

- Facilitate quarterly Provider Advisory Committee meetings

- Monitor, analyze, and report incident management performance, including trends, risks, timeliness, recurrence, investigation outcomes, and key quality metrics to drive data-informed decision making

- Develop and implement corrective actions, prevention strategies, and quality improvement initiatives based on incident data, root cause analyses, audit findings, and performance results

**Requirements:**

- Bachelor's degree

- 3+ years of people management experience

- 5+ years of experience in WI long-term care programs, Family Care, or Family Care Partnership

- 3+ years of experience in Quality Management

- 1+ year of experience in provider relations and education

- Must reside in WI or a bordering state

**Preferred Qualifications:**

- 1+ year of experience developing surveys and audit tools

- Experience in program development

- Experience engaging primary care providers such as hospitals, physicians, behavioral health practitioners

**Work Arrangements:**

- Remote work arrangement with occasional travel to Humana's offices for training or meetings

- Must have a dedicated workspace with minimal interruptions to protect member PHI/HIPAA information

- Reliable internet connection with a minimum download speed of 25 Mbps and upload speed of 10 Mbps

**Salary and Benefits:**

- Salary range: $86,300 - $118,700 per year

- Eligible for a bonus incentive plan

- Competitive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, and more

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## Skills

### Required
- Quality Management
- Provider Relations
- Survey Development
- Audit Tools
- Program Development

### Nice to have
- Primary Care Provider Engagement

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Source: [Apply at humana.wd5.myworkdayjobs.com](https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Wisconsin/Manager--Provider-Quality-Improvement_R-434627-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)