Stars Improvement Coordinator - Remote Texas

Profile

Description

The Stars Improvement Coordinator develops, implements, and manages oversight of the company's Medicare/Medicaid Stars Program. Directs all Stars quality improvement programs and initiatives. The Stars Improvement Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

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 Stars Improvement Coordinator develops programs designed to increase the plan quality. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.


Supports TX Star Improvement through member and provider outreach
Captures / shares member compliance barriers, Star improvement best practices and Star improvement opportunities
Completes 30 Individual Record Review (IRR) submissions / month, responsive to IRR audit results & documentation feedback
Supports Medical Record Review (MRR) and Admin annual data collections efforts, as requested
Outreaches to the service provider to obtain medical record/lab result to assist closing care gap
Demonstrates subject matter expertise (SME) for Star categories and individual measures
Shares best practices with peers (small group calls, bi-monthly team meetings, One Note tool) and leverage best practices during provider reviews to improve TX Stars Performance
Documents time allocation (projected and actual) across various areas of responsibility
Completes annual nurse approver certification training
Maintains nurse approver certification / access
Maintains remote access to EMR's
Maintains timely and thorough documentation (SC Summary, Outlook Calendar)
Articulates and models desired culture attributes
Maintains and updates a personal development plan
Schedules prioritized providers for reviews as requested
Supports EAF or supplemental feed conversion where possible
Timely & thorough support of processes / special projects as assigned


Required Qualifications


2 years of healthcare experience
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, Outlook and PowerPoint
Strong attention to detail and focus on process and quality
Excellent communication skills
Ability to operate under tight deadlines
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


Associate's or Bachelor's Degree in Business Administration, Health Administration or a related field
Previous experience providing support to remote teams
Stars experience
Prior EMR experience or Medical Assistant experience
Proven organizational and prioritization skills and ability to collaborate with multiple departments
Prior managed care experience
Familiarity with medical terminology and/or coding


Additional Information

Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings. Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance is required.

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

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