Quality RN Professional
Quality RN Professional
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$ 71100 - 97800
1 Vacancy
Job Description
Become a part of our caring community and help us put health first
The Quality RN Professional is responsible for the development implementation and management oversight of the Primary Care Organizations Stars Program in the Dallas market. The Quality RN Professional works assignments involving moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.The Quality RN Professional collaborates with market leadership and quality improvement team to develop and implement programs designed to increase patient outcomes. Work is performed within the associates assigned center locations and in collaboration with existing Quality Improvement Coordinators and Professionals and in close partnership with market and center teams.
The Quality RN Professional represents the scope of provider relationships across the following areas:
Quality/clinical management and population health
HEDIS and Stars performance
Operational improvements
Financial performance and incentive programs
Data sharing and connectivity
Documentation and coding
Additional areas related to provider performance member experience market growth provider experience and operational excellence
Use your skills to make an impact
Required Qualifications
Licensed Registered Nurse (RN) without restriction in applicable state
5 years of clinical nursing experience
Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement
Strong knowledge of HEDIS/Stars/CMS
Excellent presentation and communication skills both oral and written
Strong relationship building skills as this is a provider-facing role
Strong attention to detail with a focus on process and quality
Comprehensive knowledge of Microsoft Office applications
Preferred Qualification
Bachelors Degree in Nursing
3 years of managed care experience
3 years of case management experience
Bilingual; English and Spanish preferred not
Additional Information
Hours for the role are: Monday-Friday 8am-5pm local time zone
This role is based within the provider office with regular rotation through each center within the assigned territory.
Tuberculosis (TB) screening: This role is considered member facing and is part of Humanas Tuberculosis (TB) screening program. If selected for this role you will be required to be screened for TB.
Drivers License Reliable Transportation Insurance This role is part of Humanas Driver safety program and therefore requires an individual to have:
a valid state drivers license
carry insurance in accordance with the state minimum required limits or $25000/$25000/10000 whichever is higher
and a reliable vehicle.
Scheduled Weekly Hours
40Pay 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.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 volunteer time off paid parental and caregiver leave) short-term and long-term disability life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive preventive care to seniors including wellness visits physical exams chronic condition management screenings minor injury treatment and more. Our unique care model focuses on personalized experiences taking time to listen learn and address the factors that impact patient well-being. Our integrated care teams which include physicians nurses behavioral health specialists and more spend up to 50 percent more time with patients providing compassionate personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patients well-being.About CenterWell a Humana company: CenterWell creates experiences that put patients at the center. As the nations largest provider of senior-focused primary care one of the largest providers of home health services and fourth largest pharmacy benefit manager CenterWell is focused on whole-person health by addressing the physical emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM) CenterWell offers stability industry-leading benefits and opportunities to grow yourself and your career. We proudly employ more than 30000 clinicians who are committed to putting health first for our teammates patients communities and company. By providing flexible scheduling options clinical certifications leadership development programs and career coaching we allow employees to invest in their personal and professional well-being all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race color religion sex sexual orientation gender identity national origin age marital status genetic information disability or veteran status. It is also the policy ofHumanato take affirmative action to employ and to advance in employment all persons regardless of race color religion sex sexual orientation gender identity national origin age marital status genetic information disability or protected veteran status and to base all employment decisions only on valid job requirements. This policy shall apply to all 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 all levels of employment.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
