STARS Improvement Professional 2

Humana Inc.

Job Overview

Location

Remote Florida

Job Type

Full-time

Full Job Description

📋 Description

• Develop, implement, and manage oversight of the company's Medicare/Medicaid Stars Program.
• Direct all Stars quality improvement programs and initiatives.
• Develop programs designed to increase the plan quality.
• Partner with leaders regarding implementation planning.
• Review and communicate results of programs.
• Understand department, segment, and organizational strategy and operating objectives.
• Make decisions regarding own work methods.
• Follow established guidelines/procedures.
• Review provider/member-specific UM and QI metrics and coach assigned providers.
• Provide resources and educational opportunities to providers and staff.
• Promote practice-patients’ participation in clinical programs.
• Identify specific practice needs to provide support.
• Educate providers and staff about Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

🎯 Requirements

• Bachelor's Degree in Business, Finance, Health Care or a related field.
• 2+ years of clinical experience.
• Prior Medicare/Medicaid experience.
• Strong attention to detail and focus on process and quality.
• Excellent communication skills.
• Comprehensive knowledge of all Microsoft Office applications.

🏖️ Benefits

• Competitive benefits that support whole-person well-being.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.

Skills & Technologies

Remote

$71k-97k

Degree Required

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Humana Inc.

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About Humana Inc.

Humana Inc. is a for-profit health and well-being company headquartered in Louisville, Kentucky. Founded in 1961, it provides health insurance, Medicare Advantage plans, Medicaid services, pharmacy benefit management, and clinical care through primary care centers. Serving millions of members across the United States, Humana focuses on integrated care delivery, home health, and wellness programs aimed at improving health outcomes and reducing costs for individuals, employers, and government partners.

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