Become a part of our caring community and help us put health first
 

We are seeking a driven individual to support the Stars program to positively impact HEDIS measure performance accounting for significant contribution to our Star rating performance through delivery of key insights, strategic initiatives, and operational excellence. The role will support key program initiatives with project implementation, application of population insights and clinical expertise, and performance oversight to deliver and advance Stars strategy. A broad range of skills including strategic thinking, data interpretation, and program management will be required.

In this position, you will apply in-depth and broad knowledge of HEDIS measures to lead core functions and develop strategy and outreach programs to drive overall Stars performance, provide insights and identify opportunities for optimization through data analysis of variable factors to determine course of action and investment and establish key goals that will drive initiatives and align to Stars performance goals.

Regular responsibilities will include:

• Accountability for the performance and outcomes of programs critical to Humana’s ability to improve Star ratings
• Proactively engage the right stakeholders and partner with multiple analytics teams to develop, prioritize, and deliver effective solutions
• Use problem solving skills to resolve issues and make decisions in a fast pace, complex, ever-changing environment
• Apply a deep understanding of operations, with oversight and implementation responsibilities
• Effectively communicate the Stars story
• Attention to details and willingness to dig into the more minute parts of HEDIS measures and gap closure processes with limited guidance and direction to identify and implement solutions
• 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, regions and member populations
• Understanding of or experience with clinical setting to advance provider first strategies, influence member interventions and identify new opportunities to increase engagement

• Make recommendations based on reporting and monitoring by contract, region, provider, line of business, member populations 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 and analytics teams to deliver comprehensive insights to drive engagement and outcomes
• Experience identifying member populations, utilizing predictive analytics and executing custom solutions to meet their needs and drive outcomes

• Understand business goals and use them to the create, execute, and monitor initiatives
• Influence key partners across the enterprise to prioritize Stars and to develop key performance indicators to measure effectiveness and contribution

Use your skills to make an impact
 

Required Qualifications

• Minimum 8 years of experience focused on developing strategies for operational improvement

• 2 years of project leadership experience specifically within healthcare and focused on quality improvement

• Proficiency in interpreting data trends and applying to engagement strategy

• Comfortable working independently to accomplish components of a larger program

• Strong organizational and time management skills

• Superb communication skills, written and verbal

• Must be comfortable with collaboration, facilitation and communicating results to senior leadership

Desired Qualifications

• Bachelor's or Advanced degree

• Clinical experience

• Stars/HEDIS experience

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
• Associates 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 associates 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