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Humana Senior Stars Improvement Professional in Pittsburgh, Pennsylvania

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

Humana's Stars Improvement team is seeking a Senior Stars Improvement Professional with Medicare experience to work remote in Pennsylvania or Maryland. As the Senior Stars Improvement Professional, you will develop, implement and manage processes as part of the Northeast Region Medicare Stars Improvement Program. In this role, you will collaborate with providers in the Northeast region to improve Stars performance and partner with corporate partners and the Regional Stars team regarding progress updates on the market's performance.

Key Functions

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

  • Instill focus on Stars/Quality performance

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

  • Actively support team engagement performance, well-being improvement plans, and team activities

  • Articulate and model desired culture attributes

To be successful in this role, you must be very detail oriented with a focus on process and quality. Having excellent communication skills, both written and verbal, and being able to operate under tight deadlines are also critical to success.

This position is an hourly remote role but could require occasional in-person collaboration with providers located in your state (PA or MD) depending on business needs.

Use your skills to make an impact

Required Qualifications

  • Must live in PA or MD

  • Prior Medicare experience

  • Provider engagement/education, risk adjustment or related experience

  • Understanding of CMS Stars, performance measures

  • HEDIS knowledge and experience

  • Background working in quality improvements

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

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

Preferred Qualifications

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

  • Progressive experience in the health solutions industry

  • Prior managed care experience

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

  • Coding 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

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:

  • Health benefits effective day 1

  • Paid time off, holidays, volunteer time and jury duty pay

  • Recognition pay

  • 401(k) retirement savings plan with employer match

  • Tuition assistance

  • Scholarships for eligible dependents

  • Parental and caregiver leave

  • Employee charity matching program

  • Network Resource Groups (NRGs)

  • Career development opportunities

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.$76,800 - $105,800 per yearThis 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 because he or she is a protected veteran. 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.

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