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Job Information

Humana Senior Stars Improvement Clinical Professional (RN) - Work at Home Colorado or Work at Home Arizona in Colorado Springs, Colorado

Description

The Senior Stars Clinical Professional (RN) works through phone calls and other outreach methods with members, providers, and/or vendors to close HEDIS care gaps. The Senior Stars Clinical Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors with the intent to improve the overall performance of the market on Quality results.

How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Responsibilities

The Senior Stars Clinical Professional (RN) works through phone calls and other outreach methods with members, providers, and/or vendors to close HEDIS care gaps. The work is primarily phone work requiring long periods of sitting. Outreach reach assignments will change and be varied throughout the year. The position partners with leaders and the Stars team regarding progress on the market's performance. Ability to document and communicates results of programs is required.

  • Reach out to members, providers and/or vendors to close care gaps

  • Will work and collaborate with nurses on the team

  • Prioritize work responsibilities

  • Use strong decision making and triage skills

  • Be flexible and pivot with the work assignments on a regular basis

Required Qualifications

  • An active Registered Nurse (RN) License free of restrictions

  • 2+ years of clinical experience

  • Prior Medicare/Medicaid experience or health care experience

  • Strong attention to detail and focus on process and quality

  • Excellent communication skills

  • Ability to operate under tight deadlines

  • Ability to work closely with collaborative remote teams

  • Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Bachelor's Degree or Master's Degree in Business, Finance, Health Care or a related field

  • Understanding of CMS Stars, performance measures, HEDIS knowledge and experience

  • Background working in quality improvements

  • Progressive experience in the health solutions industry

  • Prior managed care experience

  • Understanding of metrics, trends and the ability to identify gaps in care

  • Proven organizational and prioritization skills and ability to collaborate with multiple departments

  • Coding experience

Additional Information

This position will be located in Colorado or Arizona and may require periodic travel.

Our Hiring Process

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m (satellite and/or wireless internet connections are NOT permitted for Work at Home roles) and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

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