Stars Program Delivery Lead - HEDIS

Humana

1d • Hybrid

About The Position

The Stars Program Delivery Lead strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Program Delivery Lead works on problems of diverse scope and complexity ranging from moderate to substantial. 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 to develop strategy and implement comprehensive solutions to drive overall Stars performance: Accountability for performance and operational excellence of comprehensive programs to improve Star ratings Partner with multiple analytics teams to develop, prioritize, deliver, and measure solutions Proactively engage the right stakeholders to anticipate headwinds and identify gaps, looking ahead to anticipate pivots and action needed
Provide insights and identify new opportunities for improvement through data analysis of variable factors to determine course of action: Ability to make recommendations based on reporting and monitoring by contract, region, provider and aggregate performance, identifying where things are going well and why, as well as where things need to improve and how Cross-collaboration with performance management team to interpret and deliver key recommendations to achieve Stars goals
Conduct audits of all data collection and processes to ensure operational excellence across initiatives: Create standard operating procedures, document data collection, and establish processes for audit and quality control Identify gaps and new opportunities to improve performance
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 and willing to learn the more minute parts of HEDIS measures and gap closure processes with limited guidance and direction Use problem solving skills to resolve issues and make decisions in a fast pace, complex, ever-changing environment Understand campaign development to provide insights for new concepts, technologies or processes Experience with market needs to provide insights to improve performance in key contracts and regions Understanding of or experience with clinical setting to advance provider first strategies, influence member interventions and identify new opportunities to impact

Requirements

• Bachelor’s Degree or equivalent work experience
• 7 or more years of operations, program management and/or strategy experience
• 2+ Medicare Stars and HEDIS knowledge or experience
• Experience leading special projects and producing metrics, measurements and reports
• 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

Nice To Haves

• Master’s degree
• Care of Older Adults (COA) measure experience or SNP Clinical experience

Responsibilities

• Strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics.
• Works on problems of diverse scope and complexity ranging from moderate to substantial.
• Applies in-depth and broad knowledge of HEDIS measures to develop strategy and implement comprehensive solutions to drive overall Stars performance.
• Accountable for performance and operational excellence of comprehensive programs to improve Star ratings.
• Partners with multiple analytics teams to develop, prioritize, deliver, and measure solutions.
• Proactively engages stakeholders to anticipate headwinds and identify gaps, looking ahead to anticipate pivots and action needed.
• Provides insights and identifies new opportunities for improvement through data analysis of variable factors to determine course of action.
• Makes recommendations based on reporting and monitoring by contract, region, provider and aggregate performance.
• Cross-collaborates with performance management team to interpret and deliver key recommendations to achieve Stars goals.
• Conducts audits of all data collection and processes to ensure operational excellence across initiatives.
• Creates standard operating procedures, documents data collection, and establishes processes for audit and quality control.
• Identifies gaps and new opportunities to improve performance.
• Supports key functions with strategic and analytical thinking.
• Communicates the Stars story effectively.
• Understands technical specifications and codes within attributed value sets.
• Uses problem-solving skills to resolve issues and make decisions in a fast-paced, complex, ever-changing environment.
• Understands campaign development to provide insights for new concepts, technologies or processes.
• Uses market needs to provide insights to improve performance in key contracts and regions.
• Uses understanding of or experience with clinical setting to advance provider first strategies, influence member interventions and identify new opportunities to impact.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees