• You will work with providers to improve their STARs ratings and overall performance through strategic initiatives and strong relationship-building
• Stars/Quality Program Expertise : Serve as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience
• Collaborate to develop tailored action plans and communicate actionable insights to improve performance
• Performance Improvement : Actively monitor and analyze provider performance data to identify areas for improvement
• Implement strategies to enhance outcomes and provide ongoing support and guidance to providers
• Resource Liaison : Act as a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools
• Facilitate communication between providers and internal teams to ensure seamless access to necessary resources and support
• Educate provider groups on reward programs and target metrics, collaborating to achieve established goals

Monitor and report on the effectiveness of reward programs, making recommendations for enhancements as needed Provider Abrasion Resolution:

• Resolve provider abrasion issues effectively, ensuring a positive and collaborative relationship between Humana and its providers
• Implement strategies to minimize provider abrasion and enhance overall satisfaction

Internal Collaboration : Partner with internal teams to track and report on market performance, ensuring alignment with organizational goals *Use your skills to make an impact Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required Scheduled Weekly Hours**

• 2 or more years of Experience with Medicare and/or managed care
• 3 or more years of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system experience
• 1 or more years of experience understanding of Consumer / Patient Experience
• 2 or more years of experience building relationships with physician groups and influencing execution of recommended strategy
• 1 or more years of experience with focus on process and quality improvement
• Comprehensive knowledge of Microsoft Word, Excel and PowerPoint
• Work during 8am-5pm CST or EST
• Travel a minimum of 10%
• Live in EST or CST state
• Strong communication and presentation skills, both verbal and written, and experience presenting to internal and external customers, including high-level leadership
• Bachelor's Degree Understanding of and ability to drive interoperability
• Progressive experience with interoperability solutions in Healthcare
• Proven organizational and prioritization skills and ability to collaborate with multiple
• Experience with Medicare Risk Adjustment and/or medical coding
• Understanding of metrics, trends and the ability to identify gaps in care
• 1 or more years' experience with tools such as Power BI, Tableau, Qlikview
• If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided
• To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates 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 associates 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

Lives in the region IN, KY, MI, OH, WV

Reward Programs: *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
• 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