8 days old

Manager, Stars Improvement, RN - Remote Work at Home witthin South Florida Market Locations Only

Humana
Miami, FL 33126
Description The Manager, Stars Improvement, Clinical responsible for the development, implementation and management oversight of the company's Medicaid Stars Program. The Manager, Stars Improvement, Clinical works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Responsibilities The Manager, Stars Improvement, Clinical develops programs designated to increase the plan quality. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Decision This work focuses on areas of clinical emphasis. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department. General Duties/Responsibilities: + Responsible for daily operations of the clinical advisors (clinical and non-clinical) in the department, including assignment, visit tracker, develop and monitor the clinical advisor score card, issue resolution and training + Collaborate with cross-functional departments, including Clinical, Community Management, Member Services, and Provider Network & Contracting, to drive provider/member engagement + Drive enterprise adoption of a consume centric approach, leverage consume analytics in order to develop insights for member/provider engagement strategies, highly effective communication campaigns, member journeys, and programs to improve customer engagement, retention, and health outcomes + Define the key performance indicators to benchmark and track initiative success + Create leadership/executive presentations that communicate opportunities and progress Required Qualifications + Active Unrestricted Registered Nurse, (RN), License in the state of Florida + Bachelors Degree in Health Care or a related field + 3+ years of managed care experience + Experience clinical and quality background as a RN + 1+ years combination professional and management experience within the following; team lead, or charge nurse, project,/process leadership, or Subject Matter Expert, SME. + Progressive business consulting and/or operational leadership experience + Knowledge of HEDIS quality measures + Proficiency in analyzing and interpreting healthcare data and trends + Strong attention to detail, focus on process, quality, and ability to operate under tight deadliness + Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, Access and PowerPoint + Excellent written and oral communication skills + Must be passionate about contributing to an organization focused on continuously improving consumer experience Additional Requirements: Hours: 8:00 AM-5:00 Eastern Time Monday through Friday Location: Position requires location in South Florida market to include + Miramar, Miami, Fort Lauderdale, Doral, Boca Raton areas Travel: + The work style for this position is primarily based from a home office with 20% travel within the state of Florida and as business needs. + Possession of a valid driver's license and access to a reliable automobile Remote Work at Home Requirements: + Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work + Must have accessibility to hardwired high speed internet with minimum speeds of 10Mx1M for a home office (Wireless and Satellite are prohibited) Preferred Qualifications: + Masters Degree in Health Administration or a related field + Previous management/supervisor level experience to include hiring, training, coaching up to termination + Experience with Quality and HEDIS Medicaid + 3+ years of experience in the healthcare industry Additional Information Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request. <>

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Posted: 2019-12-04 Expires: 2020-01-03

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Manager, Stars Improvement, RN - Remote Work at Home witthin South Florida Market Locations Only

Humana
Miami, FL 33126

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