RN - Senior Stars Improvement Professional

Profile

Job Information

Humana

RN - Senior Stars Improvement Professional

in

Springfield

Missouri

Description

The RN 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, specifically focusing on CAHPS and HOS scores. This position will lead our member engagement and outreach program to ensure members get the care they need. 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 RN Senior Stars Improvement Professional develops programs designed to increase the plan quality. This position will lead our member engagement and outreach program to ensure members get the care they need. 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.

Required Qualifications

An active Registered Nurse (RN) License free of restrictions

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

5 or more 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

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

Master's Degree in Business Administration, Health Administration or a related field

Progressive experience in the health solutions industry

Prior supervisory experience with leading a team of nurses

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

Understanding of CMS Stars, performance measures, HEDIS knowledge and experience a plus

Background working in quality improvements

Coding experience a plus

Additional Information

For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination, including booster or commit to testing protocols

*OR  *

Provide proof of applicable exemption including any required supporting documentation

​​Medical, religious, state and remote-only work exemptions are available.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com