Healthcare Improvement Consultant

2 weeks ago


Tallahassee, United States Humana Full time

About the Role: We are seeking a Senior STARS Improvement Consultant/Professional to join our Humana team. This role is responsible for implementing and managing highly visible Pharmacy development strategies, working closely with business partners, and managing critical features of large-scale projects.

Responsibilities:

  • Critical thinking and initiative to manage multiple projects with resilience
  • Strong coordination, written, and verbal communication skills
  • Execution and outreach of Pharmacy initiatives, presenting opportunities for improvement
  • Maintaining strong relationships with assigned physician groups, influencing execution of recommended strategies
  • Collaborating with internal partners (PE, MRA, Interop, Clinical Team)
  • Instilling focus on Stars/Quality performance
  • Developing and leading presentations to promote performance improvement
  • Supporting team engagement and well-being improvement plans
  • Articulating and modeling desired culture attributes and Humana values
  • Educating physician groups on reward programs and target metrics
  • Data interpretation and analysis
  • Drafting and reviewing documents

Requirements:

  • Bachelor's Degree
  • 2 or more years of Healthcare experience
  • Understanding of metrics, trends, and ability to analyze gaps in care
  • Experience in completing efficient data analysis with conclusions and recommendations
  • Comprehensive knowledge of Microsoft Office applications (Word, Excel, PowerPoint)
  • Living in Florida

PREFERRED QUALIFICATIONS:

  • Master's Degree in Business Administration, Health Administration, or related field
  • Understanding of CMS Stars, performance measures, HEDIS knowledge, and experience
  • Pharmacy management experience
  • Self-starter with high level of accountability and desire to excel in fast-paced environment
  • Progressive experience in health solutions industry
  • Prior managed care experience
  • Background working in quality improvements
  • Experience with SQL and tools like SAS, Power BI, SSIS, Power Apps, Tableau, Qlikview, and Microsoft Access
  • Data analysis and relational databases experience

Estimated Salary Range: $76,800 - $105,800 per year

Description of Benefits: Humana offers competitive benefits that support whole-person well-being, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and more.

About Humana: Humana is committed to putting health first – for our teammates, customers, and company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health.



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