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Humana Senior Stars Improvement, Clinical Quality-3 in Davenport, Iowa

Description

The Senior Stars Improvement, Clinical Professional is responsible for the development, implementation and management oversight of results related to a regional Medicare Stars program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation including creation and execution of a related action plan.

Responsibilities

The Senior Stars Improvement, Clinical Professionals work focuses specifically on developing relationships and influencing behaviors and processes in areas requiring clinical emphasis. The role will:

  • Execute and contribute to the overall Star Improvement department’s strategy

  • Work within specific guidelines and procedures

  • Apply advanced clinical knowledge to drive member patient outcomes and improved provider quality performance

  • Receive assignments in the form of objectives and must determine approach, resources, schedules and goals

  • Exercise considerable latitude in determining objectives and approaches to assignments

  • Require cross departmental collaboration, and conducting briefings and area meetings with internal and external partners and leaders

  • Maintain frequent contact with other professionals and leaders across the markets departments

Required Qualifications

  • An active Registered Nurse (RN) License free of restrictions

  • 5 or more years of clinical experience

  • Prior Medicare experience

  • Strong attention to detail and focus on process and quality

  • Proven organizational and prioritization skills and ability to collaborate with multiple departments

  • Excellent communication skills

  • Ability to operate under tight deadlines

  • Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

  • This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits

Preferred Qualifications

  • Bachelor's Degree in Business, Finance, Health Care or a related field

  • Progressive experience in the health solutions industry

  • Prior managed care experience

  • Understanding of metrics, trends and the ability to identify gaps in care

  • Understanding of CMS Stars performance measures, HEDIS knowledge and experience

  • Background working in quality improvement

  • Coding experience a plus

Additional Info

This role will be based in MN, IA, NE or SD and will require regional travel.

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.

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