Stars Program Delivery Lead – Colon Cancer Screening

📋 Description

• • As a Stars Program Delivery Lead at Humana, you will be instrumental in shaping and executing strategies that significantly enhance the quality metrics and value-based relationships within our provider networks and member communities. This pivotal role is designed for an individual who thrives on tackling complex challenges and driving tangible improvements in healthcare outcomes, directly impacting the success of our Stars program and the well-being of our members. You will be at the forefront of identifying opportunities, developing innovative solutions, and ensuring their seamless implementation to achieve excellence in Star ratings. Your work will directly contribute to Humana's mission of making it easier for millions of people to achieve their best health by improving the quality and efficiency of care delivery.
• • In this dynamic role, your day-to-day responsibilities will encompass a broad range of strategic and operational tasks. You will be accountable for the performance and operational excellence of comprehensive programs aimed at boosting Star ratings, requiring a deep understanding of HEDIS measures and their impact. A significant part of your role will involve partnering closely with multiple analytics teams to develop, prioritize, deliver, and meticulously measure the effectiveness of various solutions. Proactive engagement with a diverse set of stakeholders will be crucial to anticipate potential challenges, identify critical gaps, and strategically pivot actions as needed to stay ahead of evolving program requirements. You will also be responsible for making data-driven recommendations based on thorough reporting and monitoring of performance across contracts, regions, providers, and aggregate levels, clearly articulating what is working well, why, and where improvements are necessary and how to achieve them. Furthermore, you will conduct detailed audits of all data collection processes and initiatives to ensure the highest standards of operational excellence, creating standard operating procedures, documenting data collection methods, and establishing robust processes for audit and quality control to identify new opportunities for performance enhancement.
• • You will collaborate cross-functionally with the performance management team to interpret key data insights and deliver actionable recommendations essential for achieving ambitious Stars goals. Your strategic and analytical thinking will support key functions by providing a general understanding of Stars operations and effectively communicating the Stars narrative. This includes a deep dive into the technical specifications and codes within attributed value sets, demonstrating a detail-oriented approach and a willingness to master the intricacies of HEDIS measures and gap closure processes with minimal supervision. You will leverage your problem-solving skills to address complex issues and make sound decisions in a fast-paced, ever-changing environment. Your expertise will also be called upon to inform campaign development, offering insights into new concepts, technologies, or processes that can drive performance. Understanding market needs will be vital to providing targeted insights for improving performance in key contracts and regions, and a grasp of clinical settings will help advance provider-first strategies, influence member interventions, and uncover new avenues for positive impact.
• • Within this role, you will have the opportunity to develop and deepen your expertise in Medicare Stars and HEDIS measures, becoming a subject matter expert in quality improvement initiatives. You will gain invaluable experience in program management, strategic planning, and cross-functional collaboration within a leading healthcare organization. The position offers a unique chance to influence healthcare delivery at a significant scale, contributing to better health outcomes for a large member population. You will hone your analytical and problem-solving skills by tackling diverse and complex challenges, and develop strong communication and stakeholder management abilities by working with various internal teams and external partners. This role provides a platform to learn and grow within the healthcare industry, particularly in the areas of quality performance, value-based care, and operational efficiency, preparing you for future leadership opportunities within Humana.
• • The team you will be joining is dedicated to driving excellence in healthcare quality and member satisfaction through strategic program development and execution. This group is composed of passionate professionals who are committed to making a difference in the lives of Humana's members. You will collaborate with talented individuals from analytics, operations, and clinical backgrounds, fostering a supportive and innovative work environment. The company, Humana Inc., is a prominent U.S. healthcare company committed to improving the health and well-being of its members through its insurance services and healthcare services. Humana is dedicated to fostering a culture of care, innovation, and continuous improvement, providing a stable and rewarding environment for its employees.