RN Quality Improvement for STARS/HEDIS & Population Health

CommunityCare, Inc.; Tulsa (OK); On-site; USD 65,000 - 90,000; Full time

Job summary

The Registered Nurse for Stars Quality at CommunityCare, Inc. leads efforts to improve Medicare Advantage STARS ratings by developing and implementing initiatives that manage chronic conditions and promote preventive care.

You will collaborate with interdisciplinary teams, providers, and community resources to ensure members receive high-quality, cost-effective care and to close gaps in care. Ideal candidates have BSN, 2–3 years in clinical nursing, and RN license, with experience in managed

Qualifications

• Graduate from an accredited School of Nursing; BSN preferred.
• 2-3 years of clinical nursing experience (acute care, community health, or case management).
• Experience in a managed care environment or value-based care strongly preferred.
• Active, unrestricted RN license in the state of employment or compact state.

Responsibilities

• Monitor and track member data to identify and close gaps in care for preventive screenings and chronic disease management measures (HEDIS/STARS).
• Coordinate services across the continuum of care, including post-discharge follow-ups, to ensure seamless transitions and reduce preventable hospital admissions and readmissions.
• Engage members through various methods (phone, secure messaging) to promote self-management goals and adherence to treatment plans.
• Utilize EHR and population health systems to document patient interactions, monitor outcomes, analyze data trends, and participate in quality improvement activities.
• Educate providers and office staff on population health initiatives, HEDIS/STARS measures, and best practices for improving quality outcomes.
• Serve as a patient advocate, addressing social determinants of health and collaborating with social/behavioral health workers and community organizations.
• Perform other job-related duties as assigned.

Skills

Clinical assessment

Critical thinking

Communication skills

Interpersonal skills

Patient engagement

Cultural competence

EHR proficiency

Independent work

Time management

Team collaboration

Education

Graduate from an accredited School of Nursing

Bachelor's Degree in Nursing (BSN) preferred

Tools

EHR systems

Clinical software platforms

Job description

The Registered Nurse for Stars Quality at CommunityCare, Inc. leads efforts to improve Medicare Advantage STARS ratings by developing and implementing initiatives that manage chronic conditions and promote preventive care.

You will collaborate with interdisciplinary teams, providers, and community resources to ensure members receive high-quality, cost-effective care and to close gaps in care. Ideal candidates have BSN, 2–3 years in clinical nursing, and RN license, with experience in managed