Senior Quality Compliance Professional

Humana

Quality Compliance Professional focusing on EPSDT and maternal health services. Analyzing data and improving performance for Ohio Medicaid enrollees.

Posted 6/4/2026full-timeOhio • 🇺🇸 United StatesSenior💰 $78,400 - $107,800 per yearWebsite

About the role

Key responsibilities & impact

ensure member receipt of all EPSDT/HealthChek Services
ensure member receipt of maternal health and postpartum care
promote family planning services
promote preventive health strategies
identify and coordinate assistance for identified member needs specific to maternal/child health and EPSDT
interface with community partners and pregnancy related services coordinators
participate in EPSDT, maternal health and child quality performance improvement efforts

Requirements

What you’ll need

Must reside in the state of Ohio
Unrestricted Registered Nurse in the State of Ohio OR Physician's Assistant OR Master's degree in health services, public health, or health care administration or another related field OR Certified Professional in Health Care Quality (CPHQ) OR Certified Health Care Quality Management (CHCQM)
At least 3 years of experience in either delivering EPSDT services OR Health Care Quality Improvement
Prior experience in a fast paced insurance or health care setting
Knowledge of EPSDT and Child Health Services
Knowledge of Maternal and Pregnancy related services
Understanding of healthcare quality measures (example HEDIS)
Advanced Excel experience (pivot tables, charts, formulas)

Benefits

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

EPSDT servicesHealth Care Quality Improvementmaternal healthpostpartum carefamily planning servicespreventive health strategieshealthcare quality measuresadvanced Excelpivot tablesformulas

Certifications

Registered NursePhysician's AssistantMaster's degree in health servicesMaster's degree in public healthMaster's degree in health care administrationCertified Professional in Health Care Quality (CPHQ)Certified Health Care Quality Management (CHCQM)