Humana

About Humana

 

Job Category:

Risk & Compliance - Risk Management

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full time

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Quality Assurance Technician

Humana - San Juan Rico, United States

Posted: 08/9/2018

Description

The Quality Assurance Technician develops and implements programs to establish and maintain quality standards of existing products and services, as well as developing programs to focus employees on the quality of care given to patients. The Quality Assurance Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

The Quality Assurance Technician develops policies, procedures and methods to check operational quality and improve same. Trains and/or coaches staff and management in areas such as quality improvement, process management and reliability science. Maintains communications with administration, medical staff and department heads regarding quality assurance activities. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

               

Required Qualifications

  • High School Diploma
  • Proficiency in Microsoft Office Programs, including Word and Excel Prior call center or claims processing experience required
  • Self-starter and able to succeed with minimal supervision or direct managerial oversight
  • Strong analytical and decision making skills
  • Excellent verbal communication skills

Preferred Qualifications

  • Associates or Bachelor Degree
  • Experience in healthcare and/or Medicare Advantage
  • Quality audit background desired
  • Six Sigma Knowledge desired

Scheduled Weekly Hours

40

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