Senior STARS Quality Improvement Clinician (Remote)

Humana; Florida; À distance; USD 78 000 - 108 000; Plein temps

Résumé du poste

Humana is seeking a Senior Stars Improvement, Clinical Professional in Florida to influence department strategy and decisions on moderately complex clinical initiatives. The role demands collaboration with cross-functional teams and a focus on quality metrics.

You will actively engage providers during virtual visits to drive HEDIS outcomes, educate on Medicaid CAHPS initiatives, and support performance improvement for assigned providers. Travel may be required for training and meetings.

Qualifications

• RN license in Florida
• Bachelor's degree in nursing
• Experience with Medicare/Medicaid or dual eligible populations
• Prior experience in a fast-paced insurance or health care setting
• Understanding of healthcare quality measures STARS, HEDIS, etc.
• Experience collaborating with cross-functional teams
• Proficiency in Microsoft Word, Excel and PowerPoint
• Proven analytical skills
• Excellent communication skills, both oral and written

Responsabilités

• Continue to focus efforts and identify opportunities on performance improvement for assigned providers
• Actively engages provider during virtual visit to facilitate education, HEDIS outcomes, care of members and bi-directional feedback
• Attends JOCs with providers and participates in active discussions on HEDIS, member care, and clinical/quality outcomes
• Communicate clinical quality initiatives to assigned providers
• Educate and assist providers in reducing potential preventable events
• Educate providers and staff about Medicaid CAHPS survey

Connaissances

FL RN License

Florida Residency

Nursing Degree

Medicare/Medicaid experience

Insurance/Healthcare experience

Cross-functional collaboration

MS Office

Formation

Bachelor's degree in nursing

Outils

Word

Excel

PowerPoint

Description du poste

Humana is seeking a Senior Stars Improvement, Clinical Professional in Florida to influence department strategy and decisions on moderately complex clinical initiatives. The role demands collaboration with cross-functional teams and a focus on quality metrics.

You will actively engage providers during virtual visits to drive HEDIS outcomes, educate on Medicaid CAHPS initiatives, and support performance improvement for assigned providers. Travel may be required for training and meetings.