Pharmacy Stars Improvement Lead

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $104k - $143k / year

⏰ Full Time

🟠 Senior

💊 Pharmacist

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Autonomously develop, implement, and manage clinical program strategies to improve Medicare members' medication adherence and appropriate medication use • Focus on telehealth and in-home methods of care delivery • Contribute to Humana's Pharmacy Stars team's patient safety measure performance • Exercise independent judgment and decision-making on complex issues • Analyze variable factors to determine the best course of action • Work under minimal supervision • Participate in HireVue interviewing technology as part of the hiring process • Occasional travel to Humana offices for training or meetings may be required

🎯 Requirements

• Bachelor's Degree in Business, Finance, Health Care or a related field • 2 or more years of project leadership experience • Prior Medicare/Medicaid experience • Strategic thinking and planning capabilities; organized and detail-oriented • Excellent communication skills • Enthusiasm and motivation; confident change-agent; strong oral and written presentation skills • Ability to operate under tight deadlines • Comprehensive knowledge of Microsoft Office applications, including Word, Excel and PowerPoint • Passion for contributing to an organization focused on continuously improving consumer experiences • Preferred: Medication prescribing and medical coding experience as PA, NP, or BSN • Preferred: Master's Degree in Business Administration, Health Administration or a related field • Preferred: Progressive experience in the health solutions industry • Preferred: Provider relations experience • Preferred: Prior managed care experience • Preferred: Understanding of metrics, trends, and ability to analyze and identify gaps in care • Preferred: Proven organizational and prioritization skills and ability to collaborate with multiple departments • Preferred: Understanding of CMS Stars and performance measures • Preferred: HEDIS knowledge and experience • Preferred: Background working in quality improvements • Minimum download speed of 25 Mbps and upload speed of 10 Mbps for self-provided internet service • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Telephone equipment appropriate to business requirements • Bi-weekly internet expense payment for employees living and working from home in California, Illinois, Montana, or South Dakota