Senior Clinic Operations Strategy Professional

Overview

Become a part of our caring community and help us put health first

The Senior Clinic Operations Strategy Professional develops, implements, and manages oversight of the Primary Care Organizations Medicare Advantage Stars Program. The Senior Clinic Operations Strategy Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Clinic Operations Strategy Professional will serve the PCO through detailed tracking of Stars performance for each Value-based agreement at the national and market level to ensure early identification of gaps and areas of focus based on performance for each of those contracts and monitoring of market level performance against projections and targets.

• Identifies key areas of focus for quality star rating improvement in the Primary Care Organization (PCO) using data analytics

• Develops customized, dynamic, reports and dashboards to track performance for the PCO relative to Value Based Contract Requirements for multiple payors

• Tracks market level Stars performance against measurement projections and goals

• Maintains collaborative relationships with internal partners (Data Analytics, Performance and Trend, Clinical, Contracting, and Finance)

• Is a critical thinker who has initiative to manage multiple projects with resilience, flexibility, and a high level of independent thinking

• Has experience in value-based care arrangements

• Has strong written and verbal communication skills

• Bachelor's Degree in Business, Healthcare, or other relevant area

• 2 or more years of healthcare data analysis experience (in the past 5 years)

• 1 or more years’ experience with tools such as SAS, Power BI, SSIS, Power Apps, Power Automate, Tableau, Qlikview and/or Microsoft Access

• Experience with Running analysis, automating processes, creating dashboards, self-service tools, and/other data visualizations

• Comprehensive knowledge of Microsoft Office Applications including Word, and Power Point

• Understanding of metrics, trends and the ability to draw insights from provided data to identify gaps in strategy

• Experience in completing efficient analysis of data with associated conclusions and recommendations for improvement

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and Power Point

• Master's Degree in Business Administration, Health Administration or a related field

• Understanding of CMS Stars, performance measures, HEDIS knowledge and experience

• Pharmacy management experience

• Self-starter with a high level of accountability and a strong desire to excel in a fast-paced, highly-demanding environment

• Progressive experience in the health solutions industry

• Prior managed care experience

• Background working in quality improvements

• Proven organizational and prioritization skills and ability to collaborate with multiple departments

• Data analysis, experience with relational databases

• To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
  At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees 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 employees 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.

• Travel:
  While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours
40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)…