Note: The job is a remote job and is open to candidates in USA. Humana, a leading U.S. healthcare company, is seeking a Clinical Quality Assurance Specialist to enhance patient care and ensure regulatory compliance. The role involves collaborating with clinical teams, providing education, conducting audits, and supporting quality improvement initiatives.
Responsibilities
- Collaborate with branch leadership to develop and implement quality assurance and performance improvement strategies
- Provide education and coaching to field clinicians and case managers, including instructor-led sessions
- Support branches in regulatory compliance, survey readiness, and quality improvement plans
- Help with new hire onboarding and training focused on clinical documentation, OASIS, and regulatory requirements
- Conduct chart audits and data analysis, delivering applicable feedback to improve clinical quality and compliance
- Monitor and support quality investigations and compliance processes
- Partner with leadership to identify trends, gaps, and opportunities for improvement
- Contribute to special projects and organizational plans as assigned
Skills
- Current state license as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
- Home health experience
- Proficiency in OASIS, CMS regulations, and clinical documentation standards
- 2+ years of training and learning development experience
- Understanding of curriculum design and adult learning principles
- Experience using several training tools to facilitate to a wide audience
- COS-C certification
- Experienced with Wellsky/Kinnser or comparable healthcare EMR platforms
- Bilingual (English and Spanish speaker)
Benefits
- Bonus incentive plan
- 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
Company Overview
Humana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is http://www.humana.com.Company H1B Sponsorship
Humana has a track record of offering H1B sponsorships, with 91 in 2026, 282 in 2025, 246 in 2024, 284 in 2023, 274 in 2022, 212 in 2021, 84 in 2020. Please note that this does not guarantee sponsorship for this specific role.