Location: remote (If in driving distance to Louisville office role will be hybrid which is a combination of in office and work at home)
Apply in-depth and broad knowledge of HEDIS measures process management skills and operational expertise to develop strategy and implement comprehensive business and technical solutions to drive overall Stars performance.
Accountability for development implementation performance and operational excellence of comprehensive test kit programs that improve Star ratings
Proactively engage with measure owners Marketing and other stakeholders to ensure alignment between HEDIS/Star measure strategy and test kit strategy
Partner with test kit vendors Humana business partners and technical teams to develop prioritize deliver and monitor test kit solutions
Provide test kit-related consultation for all aspects of Humanas business CenterWell ACO Reach external consultants etc.
Manage day-to-day operations and vendor management responsibilities
Provide insights identify opportunities for improvement and propose technical enhancements through process management and data analysis
Manage and enhance test kit tools and processes to provide transparency and functionality to test kit stakeholders
Cross-collaboration with business and technical teams to define and deliver key recommendations to achieve Stars goals
Coordinate implementation of new vendor-delivered functionality and monitor ongoing quality of existing processes
Set strategic direction and manage day-to-day operations of all aspects of the test kit program
Define test kit program/population requirements and provide guidance for all aspects of campaign and technical program build
Partner with Humana and vendor Marketing teams to create impactful test kit communications for all delivery channels
Manage third-party relationship management and compliance duties for test kit vendors
Develop test kit education materials for internal and external use
Research and resolve test kit-related issues and complaints
Manage budget and invoice validation for test kit vendors
Support key functions with strategic and analytical thinking
Requires a general understanding of Stars operations and ability to effectively communicate the Stars story
Knowledge of the technical specifications and codes within attributed value sets
Detail oriented with focus on data quality and technical connections
Use problem solving skills to resolve issues and make decisions in a fast pace complex ever-changing environment
Understand campaign development to provide feedback for existing programs insights for new concepts and data quality monitoring for test kit orders
Inform measure strategy by providing historical context and outcomes from prior year programs
This role requires up to 10% travel
Required Qualifications
Bachelors Degree or equivalent work experience
8 years of operations program management and/or vendor management experience
Medicare Stars and/or HEDIS experience
Experience leading special projects and producing metrics measurements and reports
Understanding data to solve problems
Proficiency in interpreting data trends and applying to operations
Demonstrated ability to articulate ideas effectively in both written and oral forms
Comfortable working independently to accomplish components of a larger program
Strong organizational and time management skills
Preferred Qualifications
Masters degree
HEDIS knowledge or experience
Additional Information
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.
Satellite cellular and microwave connection 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.
Humana 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.
As part of our hiring process for this opportunity we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for you.
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number if it is not already on file. When required an email will be sent from with instructions on how to add the information into your official application on Humanas secure website.
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.
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 protected veteran status. It is also the policy of Humana to take affirmative action in compliance with Section 503 of the Rehabilitation Act and VEVRAA to employ and to advance in employment individuals with 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.
Humana är en ledande nordisk omsorgskoncern med verksamhet inom individ- och familjeomsorg personlig assistans äldreomsorg och bostäder med särskild service enligt LSS Lagen om stöd och service för vissa funktionshindrade. Vi har 22 000 engagerade medarbetare i Sverige Norge och Finla ... View more