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

Health Quality and Stars (HQS) is an organization that is responsible for improving health outcomes and advancing the care experience of our members and provider partners through quality solutions. HQS is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS).

The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.

Location: remote or if in Louisville area then hybrid

The HEDIS Condition Management team is seeking a passionate and organized teammate to accelerate measure improvement efforts to improve HEDIS performance. The Senior Professional strategically identifies, develops, and implements programs that influence members or market leadership towards improved quality metrics. The Senior Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Due to the cross-functional nature of the work, this individual will work closely with multiple internal and external business partners to help ensure that progress is being made toward our goals. A broad range of skills including strategic thinking, data interpretation, and program management will be imperative.

• Work closely with the condition management team, Stars Operations organization and other business partners to understand goals and how initiatives support long-term strategy

• Lead initiatives through ideation, working with internal and external partners, monitoring performance, and identifying opportunities for improvement

• Partner with multiple analytics and IT teams to support the development and/or improvement of data and reporting tools, and derive actionable insights from tools

• Influence teams across the enterprise to deliver and prioritize work impacting our goals, providing education and ensuring performance oversight 

• Make decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction

• Exercise considerable latitude in determining objectives and approaches to assignments

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s Degree

• 5 years of experience previous innovation, program delivery and/ or project management experience

• Proven skills in analyzing data trends and identifying performance improvement opportunities

• Ability to present program delivery milestones and performance

• Strong attention to detail and focus on customer experience

• Demonstrated ability to articulate ideas effectively in both written and oral forms

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint, as well as ability to navigate business intelligence tools to review data insights

Preferred Qualifications

• Master’s Degree

• HEDIS experience/knowledge

• Medicare Stars experience

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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 required; 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 HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offi