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Humana Senior STARS Improvement Professional (RN) - Tucson and surrounding counties in Phoenix, Arizona

Description

The Senior Stars Improvement Professional (Quality Improvement Nurse) 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.

Responsibilities

The Senior STARS Improvement Professional (RN) 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.

  • Virtual and in-person presentations to provider groups

  • Collaborate with provider groups and internal peers to elevate STARS scores

  • Providing support and consultation to provider groups

  • STARS quality education

  • Attend weekly training

Required Qualifications

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

  • 5+ years of clinical experience

  • Prior Medicare/Medicaid experience

  • Strong attention to detail and focus on process and quality

  • Excellent communication skills

  • Ability to operate under tight deadlines

  • Ability to work closely with collaborative remote teams

  • 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

Preferred Qualifications

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

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

  • Background working in quality improvements

  • Progressive experience in the health solutions industry

  • Prior managed care experience

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

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

  • Coding experience

Additional 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.

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, 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

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.

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