Stars Provider Optimization - Senior Program Delivery Professional

Humana

21h • Remote

About The Position

Become a part of our caring community and help us put health first Health Quality and Stars (HQS) is an organization that is responsible for improving health outcomes and advancing the care experience of our members and provider partners through quality solutions. HQS is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations. The Stars Provider Optimization Lead role will focus on programs and strategies that enable providers, vendors, and Humana associates to understand Stars, implement Stars improvement strategies, report performance outcomes and ultimately ensure our Humana Medicare Advantage members are receiving quality care and achieving their best health outcomes. This role will support development of provider-facing and vendor strategy, reporting, education, and programs that drive Stars measure performance across vendor, specialist and PCP populations. The ideal candidate is a proactive problem-solver with strong communication The Senior Program Delivery Professional reports to the Director, Stars Improvement and develops programs designed to drive value-based relationships, partners with leaders regarding implementation planning, reviews and communicates results of programs. This role will partner and collaborate with: Corporate and Regional Stars leaders and teams Enterprise Partners Value Based Strategies Team External Vendors Strategic Provider Communications With the objective to: Lead creation and launch of new Provider Practice Optimization Guides for specialist and primary care practices. Translate Stars requirements into actionable workflows and best‑practice tools for providers. Develop Stars guidance and educational materials for physicians, practice staff and regional teams driving Stars performance Design and create scalable communication plans and templates Tell the Stars story by socializing performance, effort and strategy updates for and with our enterprise partners.

Requirements

• Bachelor's degree
• 5 or more years of healthcare experience
• Experience with Stars, clinical quality workflows, and/or provider practice workflows
• Ability to collaborate with others and a track record of success in managing projects and processes
• Proven presentation skills (creating content and presenting to all levels of the organization)
• Demonstrated experience building and maintaining relationships with internal and external partners/customers
• Proficiency in Microsoft Office Applications, including Word, PowerPoint and Excel
• Excellent communication skills, both oral and written
• 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
• 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

Nice To Haves

• Master's degree in business administration or a related field
• Familiarity with Power BI, Stars dashboards, or supplemental data processes
• Understanding of contracting or value-based specialty programs
• PMP certification a plus
• Strong analytical skills
• Experience with process improvement implementation

Responsibilities

• Lead creation and launch of new Provider Practice Optimization Guides for specialist and primary care practices.
• Translate Stars requirements into actionable workflows and best‑practice tools for providers.
• Develop Stars guidance and educational materials for physicians, practice staff and regional teams driving Stars performance
• Design and create scalable communication plans and templates
• Tell the Stars story by socializing performance, effort and strategy updates for and with our enterprise partners.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level