Become a part of our caring community
The Senior STARS Improvement Professional develops, implements, and provides oversight on the execution of the regional markets Medicare/Medicaid Stars quality improvement programs and initiatives. The Senior STARS Improvement Professionals work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors to recommend, manage and execute these strategies to improve overall Star ratings and provider engagement.
The Senior STARS Improvement Professional develops programs designed to increase the plans overall Star ratings and improve quality outcomes. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Use your skills to make an impact
Required Qualifications
- Experience with Medicare and/or managed care
- Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system
- Understanding of and ability to drive interoperability
- Understanding of Consumer/Patient Experience
- Experience building relationships with physician groups and influencing execution of recommended strategy
- Strong communication and presentation skills, both verbal and written, and experience presenting to internal and external customers, including high-level leadership
- Experience with focus on process and quality improvement
- Understanding of metrics, trends and the ability to identify gaps in care
- Comprehensive knowledge of all Microsoft Office Word, Excel and PowerPoint
Preferred Qualifications
- Experience with Medicare Risk Adjustment and/or medical coding
- Bachelor's degree in business, Finance, Health Care/Administration, RN or a related field, or equivalent work experience.
- Progressive experience with interoperability solutions in Healthcare
- Proven organizational and prioritization skills and ability to collaborate with multiple departments
Work at Home Requirements
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.
Application Deadline: 07-10-2026
