Humana · 1 day ago
Quality Improvement - Incidents
United States
Full-time
Remote
Mid Level
$65K/yr - $89K/yr
3+ years expHumana is seeking a Quality Improvement Professional to join the Wisconsin Medicaid Market team. The role involves monitoring incident investigations and compliance processes, managing the incident management system, and collaborating with various departments to ensure quality care and compliance with regulations.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Implement quality improvement initiatives related to incident management
Manage the Incident Management System (IMS) that connects to the state reporting system
Review, triage, and process incident reports, quality alerts, and program integrity events applying critical thinking skills to ensure sufficient detail and appropriate follow up and regulatory compliance
Act as a resource to Care Management by providing guidance and education around incident investigation and follow up
Collaborate with Quality Management Leadership and other Departments to ensure appropriate response to immediate member risk or concerns
Assist with the collection, organization, and evaluation of data from incidents, events, quality alerts, and statements of deficiency as a means to identify and address systemic quality concerns
Ensure opportunities for stakeholder involvement in activities aimed at supporting quality through the monitoring of incidents and events
Qualification
Required
Bachelor's degree or more advanced degree in the human services area (Social work, Sociology, Psychology or Nursing) and a minimum of one year experience working with elders, adults with physical disabilities or adults with intellectual disabilities OR bachelor's degree or more advanced degree in any area other than human services with a minimum of 3 years' experience working with elders, adults with physical disabilities or adults with intellectual disabilities
3 years' experience in a health insurance, health care, or long-term services and support setting
Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint
Preferred
Experience in WI long-term care programs, Family Care or Family Care Partnership, providing care management support to elders and/or adults with physical or intellectual disabilities
Experience in data collection, analysis, and reporting
Benefits
Medical, dental and vision benefits
401(k) retirement savings plan
Paid time off
Company and personal holidays
Volunteer time off
Paid parental and caregiver leave
Short-term and long-term disability
Life insurance
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
10001+ employees
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Caleb Gallifant
Chief Operating Officer, CenterWell Home Health
Recent News
2026-01-16
2026-01-16
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