RN Senior Stars Improvement Member Engagement Clinical Professional

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Job Information
Humana
RN Senior Stars Improvement, Member Engagement, Clinical Professional
in
Tulsa
Oklahoma
Description
The RN Senior Stars Improvement, Clinical Professional responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The RN Senior Stars Improvement, Clinical Professional work assignments involve member engagement to answer their questions and resolve issues, with moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
The RN Senior Stars Improvement, Clinical Professional This work focuses on areas of member engagement to answer their questions and resolve issues, with and without a clinical emphasis. 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.
Required Qualifications
Registered Nurse licensed in State of KS/MO or OK
Bachelor's Degree in Business, Finance, Health Care or a related field or a combination of education and experience
3 or more years of experience working directly with providers and/or patients
Understanding of CMS Stars, performance measures, CAHPS/HOS knowledge and experience
Strong attention to detail and focus on process and quality
Understanding of metrics, trends and the ability to identify gaps in care
Excellent communication and presentation skills
Ability to operate under tight deadlines
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
For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.If progressed to offer, you will be required to:
Provide proof of full vaccination, including booster or commit to testing protocols
*OR  *
Provide proof of applicable exemption including any required supporting documentation
​​Medical, religious, state and remote-only work exemptions are available.
Preferred Qualifications
Prior Medicare/Medicaid experience
Experience in the customer service industry
Master's Degree in Business Administration, Health Administration or a related field
Progressive experience in the health solutions industry
Prior managed care experience
Proven organizational and prioritization skills and ability to collaborate with multiple departments a plus
Background working in quality improvements
Additional Information
Role requires 20% travel within the region.
Scheduled Weekly Hours
40

Company info

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