HumanaHiring

Quality Compliance Professional

  • Remote, United States
  • Mid-level
  • Posted 5 days ago
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In one line

Remote quality improvement role in a variable staffing pool, part to full time hours, working on Medicaid quality projects for the eastern time zone.

About the role

Projects focus on closing care gaps and improving how members and providers experience care, with committee work and state reporting. Hours flex with the task at hand rather than a fixed full time load.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, United States
Seniority
Mid-level
Working hours
Eastern Time Zone hours, 8:00 AM to 4:30 PM ET
Skills
HEDIS, CAHPS, Excel, PowerPoint
Posted
30 Oct 2026
Last checked
2 Nov 2026

What you will do

  • Call members and reach out to providers to close care gaps
  • Audit medical records against clinical guidelines and regulations
  • Update quality documents such as program descriptions, work plans and evaluations
  • Take part in quality improvement and multidisciplinary committees, internal and external
  • Prepare and refresh reports, including state and Medicaid committee reports

What they look for

  • Three or more years working on member outreach for quality and performance improvement
  • Two or more years in healthcare quality improvement or quality operations
  • Knowledge of HEDIS and CMS quality measures
  • Intermediate Excel, plus Word and PowerPoint

Nice to have

  • Certified Professional in Healthcare Quality (CPHQ)

Benefits

  • Limited benefits, effective from the first day

How Keywordise applies for you

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ClaudeConnectorChatGPTConnectorMuseby Meta

Claude

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  3. Click Connect, log in to Keywordise and approve. Then send the prompt in a new chat.
Connector URL
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ChatGPT

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Connector URL
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Muse

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Message for Muse
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Muse is available in the US only for now.

Prompt
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How to connect

Questions about this job

Can I do this job remotely, and from which countries?

Yes. The posting lists Quality Compliance Professional as a remote role for candidates in the United States. On hours, the posting says: Eastern Time Zone hours, 8:00 AM to 4:30 PM ET.

What does this job pay?

The posting does not state a salary, so there is no figure to quote.

What experience is needed?

It is a mid-level role. The posting asks for: three or more years working on member outreach for quality and performance improvement; two or more years in healthcare quality improvement or quality operations; knowledge of HEDIS and CMS quality measures. Skills it names include HEDIS, CAHPS, Excel, PowerPoint.

How do I apply with Keywordise AI?

Select Apply with Keywordise AI, sign up and upload your CV. Keywordise writes a CV and a cover letter for this job from your real experience and applies for you. The 7-day free trial needs no card.

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