Stars Program Delivery Lead - HEDIS
HumanaAbout the role
Become a part of our caring community and help us put health first
The Stars Program Delivery Lead strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Program Delivery Lead works on problems of diverse scope and complexity ranging from moderate to substantial.Location: remote (If in driving distance to Louisville office, role will be hybrid which is a combination of in office and work at home)
Apply in-depth and broad knowledge of HEDIS measures to develop strategy and implement comprehensive solutions to drive overall Stars performance:
Accountability for performance and operational excellence of comprehensive programs to improve Star ratings
Partner with multiple analytics teams to develop, prioritize, deliver, and measure solutions
Proactively engage the right stakeholders to anticipate headwinds and identify gaps, looking ahead to anticipate pivots and action needed
Provide insights and identify new opportunities for improvement through data analysis of variable factors to determine course of action:
Ability to make recommendations based on reporting and monitoring by contract, region, provider and aggregate performance, identifying where things are going well and why, as well as where things need to improve and how
Cross-collaboration with performance management team to interpret and deliver key recommendations to achieve Stars goals
Conduct audits of all data collection and processes to ensure operational excellence across initiatives:
Create standard operating procedures, document data collection, and establish processes for audit and quality control
Identify gaps and new opportunities to improve performance
Support key functions with strategic and analytical thinking:
Requires a general understanding of Stars operations and ability to effectively communicate the Stars story
Knowledge of the technical specifications and codes within attributed value sets
Detail oriented and willing to learn the more minute parts of HEDIS measures and gap closure processes with limited guidance and direction
Use problem solving skills to resolve issues and make decisions in a fast pace, complex, ever-changing environment
Understand campaign development to provide insights for new concepts, technologies or processes
Experience with market needs to provide insights to improve performance in key contracts and regions
Understanding of or experience with clinical setting to advance provider first strategies, influence member interventions and identify new opportunities to impact
Use your skills to make an impact
Required Qualifications
Bachelor’s Degree or equivalent work experience
8+ years of operations, program management and/or strategy experience
2+ Medicare Stars and HEDIS knowledge or experience
Superb communication skills, written and verbal
Experience leading special projects and producing metrics, measurements and reports
Proficiency in interpreting data trends and applying to operations
Comfortable working independently to accomplish components of a larger program
Strong organizational and time management skills
Preferred Qualifications
Master’s degree
Clinical experience
Additional Information
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and dec
Apply for this role
Generate a tailored application kit with a matched cover letter, interview prep, and CV highlights — in under 60 seconds.
Apply Now →Generate Application KitFree account required — sign up in 30s