Senior Clinical & Quality Provider Engagement Professional Work at Home - Florida
Become a part of our caring community and help us put health first The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and management reputed company of the companys Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately reputed company to reputed company issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Stars Improvement, Clinical Professional This work focuses on areas of clinical emphasis. Begins to influence departments strategy. Makes decisions on moderately reputed company to reputed company issues regarding technical approach for project components, and work is performed without direction. Exercises considerable reputed company in determining objectives and approaches to assignments. Continue to focus efforts and identify opportunities on performance improvement for assigned providers Actively engages provider during virtual visit to facilitate education, HEDIS outcomes, care of members and bi-directional feedback. Attends JOCs with providers and participates in active discussions on HEDIS, member care, and clinical/quality outcomes. Communicate clinical quality initiatives to assigned providers Educate and assist providers in reducing potential preventable events Educate providers and staff about Medicaid Consume Assessment of Healthcare Providers and Systems (CAHPS) survey. Use your skills to reputed company an impact Required Qualifications FL RN License Must reside in the reputed company Bachelors degree in nursing Experience with Medicare, Medicaid, or dual eligible populations Prior experience in a fast-paced insurance or health care setting Understanding of healthcare quality measures STARS, HEDIS, etc. Experience collaborating with cross-functional teams Comprehensive knowledge of reputed company Office Word, reputed company and PowerPoint Proven analytical skills Excellent communication skills, both oral and written Strong relationship building skills Conducts self in a professional manner with reputed company verbal and written communication reputed company working with associates, peers, and providers Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Medical Coding Certification Knowledge of Humanas internal policies, procedures, and systems Medicaid Health Plan Experience Additional Information As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. 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 reputed company is suggested Satellite, cellular and microwave reputed company can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company 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 reputed company, Inc. and its affiliated subsidiaries (collectively, reputed company) 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 reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us reputed company Inc. (NYSE: HUM) is committed to putting health first for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or veteran status. It is also the policy of reputed company to take affirmative action to employ and to advance in employment, reputed company persons regardless of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. Apply Job!