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.

Location: remote or if in Louisville area then hybrid

The HEDIS Condition Management team is seeking a passionate and organized teammate to accelerate measure improvement efforts to improve HEDIS performance. The Senior Professional strategically identifies, develops, and implements programs that influence members or market leadership towards improved quality metrics. The Senior Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Due to the cross-functional nature of the work, this individual will work closely with multiple internal and external business partners to help ensure that progress is being made toward our goals. A broad range of skills including strategic thinking, data interpretation, and program management will be imperative.

• Work closely with the condition management team, Stars Operations organization and other business partners to understand goals and how initiatives support long-term strategy

• Lead initiatives through ideation, working with internal and external partners, monitoring performance, and identifying opportunities for improvement

• Partner with multiple analytics and IT teams to support the development and/or improvement of data and reporting tools, and derive actionable insights from tools

• Influence teams across the enterprise to deliver and prioritize work impacting our goals, providing education and ensuring performance oversight

• Make decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction

• Exercise considerable latitude in determining objectives and approaches to assignments

Use your skills to make an impact

Required Qualifications

• Bachelor’s Degree

• 5 years of experience previous innovation, program delivery and/ or project management experience

• Proven skills in analyzing data trends and identifying performance improvement opportunities

• Ability to present program delivery milestones and performance

• Strong attention to detail and focus on customer experience

• Demonstrated ability to articulate ideas effectively in both written and oral forms

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint, as well as ability to navigate business intelligence tools to review data insights

Preferred Qualifications

• Master’s Degree

• HEDIS experience/knowledge

• Medicare Stars experience

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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 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) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$86,300 - $118,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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.Application Deadline: 10-02-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.