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

The Senior STARS Improvement Professional develops, implements, and manages oversight of the company's Medicare/Medicaid Stars Program. Directs all Stars quality improvement programs and initiatives. The Senior STARS Improvement Professional work assignments involve 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 develops programs designed to increase the plan quality. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Responsibilities

The Senior Stars Improvement Professional works via virtual and in-person collaboration with providers to improve Pacific Southwest Region Stars performance. The position partners with Corporate partners and the Regional Stars team regarding progress on the market’s performance, as well as represents the scope of health plan/provider relationship across such areas as incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and Stars performance, operational improvements and other areas as they relate to provider performance & experience.

• Maintains collaborative relationships (Provider Engagement, Risk Adjustment, Clinical Teams, etc.)

• Responsible for provider relations and fulfillment of contractual obligations, including Stars performance, incentive programs, data sharing/connectivity, operational improvements

• Instills focus on Stars/Quality performance

• Advances our ability to communicate actionable insights at the appropriate moments of influence to drive the next best action

• Coaches assigned provider groups on gap closing opportunities and improving quality outcomes via in-person/virtual/telephone meetings

• Educates providers and staff about CMS Stars program, HEDIS, CAHPS, HOS

• Facilitates external discussions and workgroups with provider practices on improvement opportunities, workflow development, and monitoring of outcomes

• Articulates and models desired culture attributes; actively supports team engagement performance

Use your skills to make an impact

Required Qualifications

• Bachelor's Degree in Business, Finance, Health Care or a related field

• 4 or more years of clinical or healthcare experience

• Strong attention to detail and focus on process and quality

• Excellent communication skills

• Ability to operate under tight deadlines

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint

• Must be able to accommodate work hours according to MST (Mountain Time Zone) or PST (Pacific Time Zone)

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Master's Degree in Business Administration, Health Administration or a related field

• Prior Medicare/Medicaid experience

• Prior managed care experience

• Understanding of metrics, trends and the ability to identify gaps in care

• Proven organizational and prioritization skills and ability to collaborate with multiple departments a plus

• Understanding of CMS Stars, performance measures, HEDIS knowledge and experience a plus

• Background working in quality improvements

• Coding experience a plus

• Preference for candidates to reside in AZ, CO, CA, NM, or NV

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.

Work At Home / Internet Statement:

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 protect member PHI / HIPAA information.

SSN Statement:

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$86,300 - $118,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.