Senior Stars Improvement Professional - Remote Kentucky or Lexington/Eastern Kentucky

Profile

Description

The Senior STARS Improvement Professional develops, implements, and manages oversight of the company's Medicare/Medicaid Stars Program. Directs all Stars quality improvement programs and initiatives. The Senior STARS Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Responsibilities

The Senior STARS Improvement Professional develops programs designed to increase the plan quality. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.


Responsible for Stars performance of Primary Care Providers
Effectively develops, enhances and maintains provider relationships
Delivers provider/member-specific metrics and makes educated recommendations to providers on Stars programs
Understands and manipulates data and reporting to identify trends
Facilitates Stars education for internal partners and providers
Successfully promotes patients' participation in Stars programs - providing information on participation
Accurately defines gaps in member experience/member relationship with providers and facilitates resolution
Supports diverse quality improvement projects and initiatives to improve patients' education and patients' satisfaction
Collaborates with internal partners on Stars program initiatives and has the ability to prioritize accordingly


Required Qualifications


Bachelor's Degree in Business, Finance, Health Care or a related field
2 years of CMS Stars, performance measures, HEDIS knowledge or Provider engagement experience
Prior Medicare/Medicaid experience
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
Strong attention to detail and focus on process and quality
Excellent communication skills
Ability to operate under tight deadlines
Proven organizational and prioritization skills and ability to collaborate with multiple departments
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


Master's Degree in Business Administration, Health Administration or a related field
An active Registered Nurse (RN) License free of restrictions
Progressive experience in the health solutions industry
Prior managed care experience
Understanding of metrics, trends and the ability to identify gaps in care
Coding experience


Additional Information

This will be a Remote/Work at Home Kentucky with 20% travel in Eastern Kentucky.

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.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m (satellite and/or wireless internet connections are NOT permitted for Work at Home roles) and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

Company info

Sign Up Now - MiamiCrossing.com