Stars Quality RN: Care Coordination & Quality Improvement

CommunityCare HMO Inc.; Tulsa (OK); On-site; USD 65,000 - 85,000; Full time

Job summary

CommunityCare HMO Inc. seeks an experienced Registered Nurse (RN) to lead Stars Quality initiatives, focusing on improving Medicare Advantage STARS ratings and closing gaps in care.

The role involves collaborating with interdisciplinary teams, providers, and community resources to deliver high-quality, cost-effective care to members, while promoting preventive screenings and chronic disease management.

Qualifications

• Bachelor's degree in nursing; BSN preferred.
• 2-3 years of clinical nursing experience.
• Active, unrestricted RN license in the state of employment or a compact state license.
• Experience in managed care or value-based care preferred.
• Knowledge of HEDIS/STARS measures or other quality metrics is a plus.

Responsibilities

• Monitor and track member data to identify and close gaps in care for preventive screenings and chronic disease measures.
• Coordinate services across the continuum of care and assist with post-discharge follow-ups.
• Engage members via phone and secure messaging to promote self-management and adherence.
• Document interactions and outcomes in EHR and population health systems; analyze data trends.
• Educate providers and staff on population health initiatives and quality measures.
• Advocate for patients and address social determinants of health; collaborate with community resources.

Skills

Clinical assessment

Critical thinking

Communication

EHR proficiency

Independence

Multidisciplinary collaboration

English fluency

Education

BSN preferred

RN license (state or compact)

Tools

EHR systems

Job description

CommunityCare HMO Inc. seeks an experienced Registered Nurse (RN) to lead Stars Quality initiatives, focusing on improving Medicare Advantage STARS ratings and closing gaps in care.

The role involves collaborating with interdisciplinary teams, providers, and community resources to deliver high-quality, cost-effective care to members, while promoting preventive screenings and chronic disease management.