RN or LPN - Senior STARS Improvement Professional - Work at Home in Jacksonville FL

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.

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.

Required Qualifications


An active Registered Nurse (RN) License, free of restrictions, in the state of Florida or LPN license

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 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


Must reside within commuting distance of Jacksonville, FL

Travel 10-25%, pending release of travel restrictions observed due to Covid 19 guidance


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

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