Senior STARS Improvement Consultant

at  Humana

BECOME A PART OF OUR CARING COMMUNITY AND HELP US PUT HEALTH FIRST

The Senior Stars Improvement Consultant / Professional executes the overall Medicare Stars Improvement Program within the market, including development, implementation and management of strategies and relationships with physician groups and internal partners..

The Senior Stars Improvement Consultant / Professional works via virtual and in-person collaboration with providers to improve Stars performance.

• Build and maintain strong relationships with assigned physician groups to influence execution of recommended strategy, use of self-serve tools and promotion of interoperability solutions
• Maintain collaborative relationships with internal partners (PE, MRA, Interop, Clinical Team, etc.)
• Instill focus on Stars/Quality performance
• Educate physician groups on HEDIS, Patient Safety and Patient Experience and collaborate with them to drive improvement
• Develop tailored action plans and effectively communicate actionable insights at the appropriate moments of influence to improve performance
• Understand and effectively utilize corporate tools, collateral and best practices
• Maintain timely documentation and communication of progress, internally and externally
• Develop and lead presentations to physician groups to promote performance improvement
• Actively supports team engagement and well-being improvement plans
• Articulate and model desired culture attributes and Humana values
• Educate physician groups on reward programs and target metrics and collaborate with them to achieve established goals

REQUIRED QUALIFICATIONS

• 3 or more years of Medicare and/or managed care experience
• Comprehensive knowledge of all Microsoft Office Word, Excel and PowerPoint
• Experience with focus on process and quality improvement
• Experience presenting to internal and external customers, including high-level leadership
• Understanding of metrics, trends and the ability to identify gaps in care
• Willingness to travel a minimum of 10%
• Must live in LA, MS, AL, TN, TX

PREFERRED QUALIFICATIONS

• Bachelor’s degree
• Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system
• Experience building relationships with physician groups and influencing execution of recommended strategy
• Experience with Medicare Risk Adjustment and/or medical coding
• Understanding of Consumer/Patient Experience
• Progressive experience with interoperability solutions in Healthcare
• Proven organizational and prioritization skills and ability to collaborate with multiple departments

DESCRIPTION OF BENEFITS

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

ABOUT US

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Please refer the Job description for details