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Claims Quality Audit Professional

Humana

Humana

This job is no longer accepting applications

See open jobs at Humana.
Quality Assurance
Remote · Florida, USA
Posted on Thursday, January 25, 2024

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

The Claims Quality Audit Professional 2 performs prospective, concurrent, and retrospective reviews for home-based visits.

The Claims Quality Audit Professional 2 is responsible for performing timely concurrent, and retrospective reviews for home health services in accordance with company, industry, accreditation, state, and federal guidelines. This roll requires up to date knowledge on regulatory requirements, OASIS guidelines, and company standards. You will interact with clinicians, providers, leadership, and other departments as necessary for Quality Assurance and QAPI program needs. This position may also entail providing educational opportunities for improved quality and compliance for clinicians. This position is part of a Quality team and requires timely reporting to the Director of Quality Assurance and interactions with other team members regularly. This position will require organizational and time management skills to meet the reporting cadence. This position may assume other duties as assigned.


Use your skills to make an impact

Required Qualifications

  • RN License
  • 1-year experience in home health
  • Wellsky/Kinnser experience
  • OASIS knowledge

Scheduled Weekly Hours

40


About us

About onehome: onehome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients’ homes. onehome’s patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. onehome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


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 because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

This job is no longer accepting applications

See open jobs at Humana.