Nurse Senior Stars Improvement Consultant

3 weeks ago

Tampa, Florida, United States Humana Full time
About the Role

We are seeking a highly skilled Nurse Senior Stars Improvement Consultant to join our team at Humana. As a key member of our organization, you will contribute to the development, implementation, and management of our Medicare/Medicaid Five-Star Quality Rating System.

Key Responsibilities
  • Work directly with provider groups, Management Services Organizations (MSOs), and organizational leaders to impact Centers for Medicare & Medicaid Services (CMS) Star Rating categories.
  • Focus on areas of clinical emphasis related to the CMS Stars Program.
  • Develop and implement best practices to drive results within a provider network and MSO as it relates to clinical HEDIS measures.
  • Prepare and deliver training sessions, educational materials, performance reports, and presentations.
  • Collaborate with cross-functional teams to achieve quality improvement goals.
Requirements
  • Licensed Professional Nurse or Registered Nurse.
  • 3 or more years of Medicare experience.
  • 3 or more years of CMS Stars and HEDIS experience.
  • Strong knowledge of Microsoft Office XP products (Word, Excel, PowerPoint).
  • Proven analytical skills (i.e., trending and analysis of healthcare data).
Preferred Qualifications
  • Case Management, Accreditation, or Clinical Administrative experience.
  • User experience with data analysis tools (e.g. Power BI).
  • Excellent communication skills, both oral and written.
  • Prior experience in a fast-paced insurance or healthcare setting.
About Humana

Humana, Inc. is a leading healthcare company that puts health first for our teammates, customers, and company. We make it easier for the millions of people we serve to achieve their best health through our Humana insurance services and CenterWell healthcare services.

We are an equal opportunity employer and welcome applications from diverse candidates. Our company is committed to creating a workplace that is inclusive and respectful of all employees.

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