Become A Quality Consultant

* Provide high level support for UFT and ALM through tickets and e-mails Complete Proof's of Concept on new versions of the tools Test and Certify packages of our tool suite Support users as they move to new tool version Documentation including user guides, Knowledge articles to be used by the help desk and training materials.
* Provide demos and training What skills/attributes are a must have? 5
* Years experience in supporting UFT/QTP 5
* Years experience as an admin of ALM.
* Experience creating Job-aids and training materials.
* Experience resolving support tickets and working with users to resolve issues.
* Strong verbal and written communications.
* Ability to work alone or as part of a team

* Acts as the principal designer for major systems and their subsystems utilizing a thorough understanding of available technology, tools and existing designs
* Provides comprehensive consultation to business unit and IT management and staff at the highest technical level on all phases of application programming and processes for diverse development platforms, computing environments (e.g., host based, distributed systems, client server, software, hardware, technologies and tools, etc.)
* Works closely with client and IT management and staff to identify application development solutions, new or modified programs, reuse of existing code through the use of program development software alternatives, or integration of purchased solutions or a combination of the available alternatives.
* Researches and evaluates alternative solutions and recommends the most efficient and cost effective application programming solution
* May code new or modified programs, reuse existing code through the use of program development software alternatives and/or integrates purchased solutions
* Documents, tests, implements and provides on-going support for the applications

Responsible for developing and preparing documentation for NCQA and other accreditation surveys submissions Works closely with regional quality staff, health plan staff, and internal business partners to build and document compliance with accreditation standards Serves as a technical advisor for accreditation compliance Organizes and/or participates in readiness assessments in preparation for accreditation survey submissions May interface with accreditation agencies and other regulatory and compliance bodies Participates in the development and distribution of accreditation best practices Develops policies and procedures that support accreditation activities Supports implementation of quality structure at regional and national levels

* Salary Range $55,000
* yr
* Position Purpose:Performs complex (journey-level) quality improvement work.
* Identifies, develops, promotes, and implements Quality Improvement (QI) Methodology to improve clinical and process outcomes for providers.
* May train others.
* Works under general supervision, with moderate latitude for the use of initiative and independent judgment.
* Essential Responsibilities: Develops and maintains cooperative working relationships with providers, corporations and those supporting the healthcare industry.
* Interviews and conducts on-site or telephone observation to ascertain provider function, work performed and methods, processes and personnel used in order to study work problems and procedures, such as organizational change, communications and information flow.
* Documents activities, recording information such as details about site-visits, meetings, communication, presentations conducted and providers assisted; maintains databases, mailing lists, telephone networks and other information to facilitate effective ongoing communication.
* Performs assessments, interprets data gathered and develops solutions, alternative methods of proceeding, or facilitates methods to continuously improve quality and efficiency.
* Prepares, facilitates discussion, and consults with providers regarding implementation of new systems, the benefits, procedures, strategies, and/or organizational changes necessary to support the program.
* Provides consultation to providers on best practices related to system, clinical, and quality needs.
* Works with team to develop, maintain, and provide standardized resources and reports.
* Prepares and distributes education materials.
* May assist in the recruitment and participation of providers, practitioners and stakeholders for contract activities and initiatives.
* May develop quality improvement initiatives based on identified concerns and develop correspondence to address the identified concerns.
* May develop and/or present healthcare education programs such as training workshops, conferences and healthcare community presentations.
* May develop and maintain milestones for practices using project management principles.
* May train others.
* May be a lead worker.
* Participates in special projects and performs other duties as assigned

* Qualify, prioritize, and concentrate Provider visit efforts on top opportunities
* Develop, facilitate, and/or secure opportunities to positively impact Triple Aim
* Maintain client relationships, effectively address provider needs & PODS goals
* Understand the business, industry, and industry trends and use knowledge to recommend effective solutions.
* Lead and/or support collaborative business partnerships, elicit client understanding and insight to advise and make recommendations.
* Clarify scope of work commitments and deliverables, and define measurable success criteria to monitor progress toward goals.
* Deliver provider specific metrics and coach providers on gap closing opportunities
* Facilitate patients’ participation in clinical programs & identify opportunities member participation
* Define gaps in Humana’s service relationship with providers and facilitate resolution
* Identify specific practice needs where Humana can provide support
* Develop, enhance and maintain provider clinical relationship across product lines.
* Establish and foster a healthy working relationship between practice and Humana.
* Partner with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education.
* Provide resources and educational opportunities to provider and staff.
* Capture concerns/issues in action plans as agreed upon by Provider & PODS Owner
* Document action plans and details of visits and outcomes
* Look beyond metrics to identify underlying issues that contribute to gaps.
* Prioritize Analyst work for PODS specific reporting.
* Accountable for Provider Prioritization & communication of priorities to PODS team.
* Assess data, identify opportunities, and understand how the PODS drive successful Triple Aim outcomes.
* Role Essentials
* An active RN license in the designated state
* Strong interpersonal & relationship building skills
* Strong influencing, listening, and consultative skills
* Strong analytical skills, able to manipulate and interpret data
* CMS Stars/performance measures/HEDIS knowledge and/or experience
* Understanding of clinical programs
* Coding knowledge and/or experience or Office practice/ hospital experience
* Organizational and prioritization skills
* This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program.
* If selected for this role, you will be required to be screened for TB.
* Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10 panel drug test
* Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems if 10Mx1M
* Role Desirables
* Bachelor’s degree in a related field
* Proven leadership experience
* Experience in a state and/or federally regulated health care environment
* Strong business acumen to help drive metrics
* Utilization management knowledge and/or experience
* Provider and member rewards program knowledge and experience
* Reporting Relationships
* This role reports to the POD Frontline Lead.
* Additional Information
* At Humana, we know your well-being is important to you, and it’s important to us too.
* That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life.
* If you share our passion for helping people, we likely have the right place for you at Humana.
* The following policy applies ONLY to associates working in the state of Arizona: Humana is committed to providing a safe and healthy work environment and to promoting the health and well-being of its associates.
* Effective April 1, 2011, Humana has adopted a tobacco-free hiring policy that will promote a healthier workplace and will not hire users of tobacco and nicotine products.
* If you have any questions, please consult with your recruiter