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

The Senior Stars Improvement Professional is responsible for development, implementation, and management oversight of their assigned provider book of business and providing support to advance Network Performance (NP) strategy and operations. Drives provider engagement, quality improvement programs, NP team engagement and initiatives. The Senior Stars Improvement Professional work assignments involve coordinating, tracking and completion of moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Stars Improvement Professional is responsible for development, implementation, and management oversight of their assigned provider book of business and providing support to advance Network Performance (NP) strategy and operations. Drives provider engagement and quality improvement programs. The Senior Stars Improvement Professional work assignments involve coordinating, tracking and completion of moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

• Articulates and models desired cultural attributes

• Supports Stars narrative with backup data / material

• Prioritize and address financial, RA, clinical and interoperability opportunities in concert with Stars

• Drive YOY performance improvement within their assigned ‘Book of Business’

• Identifies areas of strength and opportunity for a provider Group / TIN and packages to share

• Develop and deliver a clear, strong message that invokes the appropriate response

• Utilize critical thinking to prioritize provider group / TIN, and the provider performance opportunities, based on performance value / opportunity

• Establishes and maintains effective working relationships

• Evaluate provider current state willingness to work with Humana to improve performance, identify improvement plan and escalate as appropriate

• Identify provider best practices and needs, disseminate for sharing and / or resolution

• Maintain documentation of provider visit, including focus and performance trending

• Facilitate effective collaboration and communication

• Self-directed and motivated, with proven ability to work independently given general instructions

• Accountable to work, requiring minimal day-to-day direction and supervision

• Comfortable with facilitating virtual and in-person meetings with C-suite/Management Level Executives

Use your skills to make an impact
 

Required Qualifications:

• Bachelor’s degree or higher in Business, Finance, Health Care or related field

• 2+ years of Medicare and/or Stars experience

• Understanding of CMS Stars program and performance measures

• Demonstrated proficiency with MS Office Suite (Word, Excel and PowerPoint)

• Understanding of metrics and performance trends and ability to identify performance strengths and opportunities

• History of using data to identify and prioritize opportunities and identify data driven solutions

• Persistent and curious. Driven by the why and willing to engage in detective work to seek and uncover causation and solution.

• Prior successful account management experience; proven influencer

• History of taking on roles of increased responsibilities with proven results

• Excellent communication and presentation skills, both virtually and in person

• Possess an ability to lead by influence and garner buy-in among a diverse group of stakeholders

• Organized and able to manage multiple deliverables requiring moderate to complex decision making (i.e., Project management/Account management)

• Excellent organization, collaboration and team player skills

• Detail orientated, forward looking and comfortable working with tight deadlines in a fast paced, dynamic environment

Preferred Qualifications

• Progressive experience in the Health Care industry

• Physician office practice experience or managed care experience

• Previous experience and/or knowledge of Quality Improvement or Process Improvement

• Coding experience

Additional Information

• Workstyle: This is a Remote position to reside in the following states (TX, OK or AR).

• Workdays and Hours: Monday-Friday; 40-hour work schedule CST

• Travel: There is some travel <50% of the time for this role.