Become a part of our caring community and help us put health first
 

This is a remote role that requires travel to branch locations in Maryland and Pennsylvania. You will report to the Director of Home Health Clinic Operations Strategy. This is a salaried position which includes participation in an annual incentive bonus plan of up to 25% of annual salary.

The Market Executive of Clinical Quality, you will drive clinical quality and regulatory metrics by onsite leadership in assigned market. You will be accountable for the following: clinical and survey metrics, clinical operations metrics, claims denials, AO/state survey results, risk mitigation, clinical compliance, QAPI adherence and VBP performance. Work with area operations and branch leaders on processes, initiatives and in-scope changes or updates.

Essential Functions:

• Improve clinical quality and regulatory metrics in assigned branches through coaching clinical managers and staff on improving care delivery and documentation requirements.
• Implement and monitor clinical performance of advanced clinical care programs into assigned branches.
• Monitor quality metrics for assigned Market; report main insights to AVP of Ops & Area Exec of Clinical Quality and other important Clinical/Ops partners.
• Conduct survey audits to prepare for official surveys and support locations through survey process.
• Conduct meaningful virtual/in-person branch interactions to improve performance.

Use your skills to make an impact
 

Knowledge/Skills/Expectations:

• You will be located in either Maryland or Pennsylvania (or surrounding area).
• Knowledge of business management and government regulations; expertise in relevant state regulations and survey activities.
• Analyze medical documents, financial reports and legal documents.
• Coach/mentor branch leadership and clinicians to influence changes in daily clinical activities.
• Proactively engage to identify and address issues.
• Expertise in branch-level clinical workflows an organization structure.
• Analyze clinical data to drive important insights and opportunities.
• Possess strong judgement on workflow and process improvement.
• Influence and communicate.
• Strong execution capabilities.
• 60-90 branch in person touchpoints per year.
• Travel approximately 50%-75%.

Required Qualifications:

• Bachelor's Degree in Nursing (BSN)

• RN licensure in Maryland or Pennsylvania.
• Experience with clinical quality improvement and survey preparation.

Preferred Qualifications:

• Previous experience in Home Health branch leadership (Branch Director/Administrator or Clinical Manager).
• HomeCare HomeBase (HCHB) experience.
• OASIS experience.
• Experience managing healthcare revenue.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$104,000 - $143,000 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.