Description

The Senior Stars Improvement Professional executes the overall Medicare Stars Improvement Program within the market, including development, implementation and management of strategies and relationships with physician groups and internal partners.

Responsibilities

The Senior Stars Improvement Professional works via virtual and in-person collaboration with providers to improve Stars performance.

• Builds and maintains strong relationships with assigned physician groups to influence execution of recommended strategy, use of self-serve tools and promotion of interoperability solutions
• Maintains collaborative relationships with internal partners (PE, MRA, Interop, Clinical Team, etc.)
• Instills focus on Stars/Quality performance
• Educates physician groups on HEDIS, Patient Safety and Patient Experience and collaborate with them to drive improvement
• Develops tailored action plans and effectively communicate actionable insights at the appropriate moments of influence to improve performance
• Understands and effectively utilizes corporate tools, collateral and best practices
• Maintains timely documentation and communication of progress, internally and externally
• Develops and leads presentations to physician groups to promote performance improvement
• Actively supports team engagement and well-being improvement plans
• Articulates and models desired culture attributes and Humana values
• Educates physician groups on reward programs and target metrics and collaborate with them to achieve established goals

In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:

• Medical Benefits
• Dental Benefits
• Vision Benefits
• Health Savings Accounts
• Flex Spending Accounts
• Life Insurance
• 401(k)
• PTO including 8 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
• And more

Required Qualifications

• Prior Medicare and/or managed care experience
• Experience presenting to small or large groups internally and/or externally
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
• Strong attention to detail and focus on process and quality improvement
• Understanding of metrics, trends and the ability to identify gaps in care
• Excellent communication skills, both in-person and virtually
• Ability to operate under tight deadlines
• Proven organizational and prioritization skills and ability to collaborate with multiple departments
• Passionate about contributing to an organization focused on continuously improving consumer experiences
• Willingness to travel a minimum of 10%
• Must live in TN, AL, MS, LA

Preferred Qualifications

• Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system
• Experience presenting to high-level leadership
• Experience building relationships with physician groups and influencing execution of recommended strategy
• Experience with Medicare Risk Adjustment and/or medical coding
• Understanding of Consumer/Patient Experience
• Progressive experience with interoperability solutions in Healthcare
• Bachelor’s degree in Healthcare, business, Finance or a related field

Additional Information

Work-At-Home Requirements

• To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
  • Wireless, Wired Cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
  • Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Our Hiring Process

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Humana is more than an equal opportunity employer, Humana’s dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful.

This is a remote position.

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Scheduled Weekly Hours

40