Quality Management Coordinator

 

Humana Military Healthcare Services

 

Humana Military Healthcare Services is a subsidiary of Humana Inc., one of the nation’s largest health insurance companies. As the TRICARE program administrator for the South Region of the United States, Humana Military provides health care benefits for more than 2.7 million of the nation’s active duty and their family members, and military retirees and retiree’ family members. 

  We currently have the following opportunity in the San Antonio area: 

 

QM Coordinator

 

The QM Coordinator administers and implements the HMHS Clinical Quality Management Program (CQMP) at the market level.  This includes, but is not limited to, Potential Quality Issue (PQI) analysis, medical record request and review, and maintenance of QM-related records. Consults with the Market Medical Director on cases as appropriate.  Researches quality issues; documents, tracks, closes, and trends events in QM information systems; prepares and presents cases for peer review as assigned; and documents, implements, and monitors corrective action plans to completion.  Supports market process/performance improvement initiatives. 

 

Minimum Qualifications:

 

·  RN with an active license in the state of Texas

·  3 years clinical nursing experience

·  2 years of UM or QM experience

 

Our Department of Defense contract requires U.S. citizenship for this position.

UILIZATION MANAGEMENT DINATOumana.com/careers

We offer an excellent salary and benefits package, including immediate eligibility for health/dental coverage, pre-tax savings and retirement plans.

 

For more information on these and other openings and to apply online, please visit our Web Page:

www.humana.com/careers

KEY WORD: HMHS

 

Equal Opportunity Employer

Drug-free Workplace