Pharmacy Stars Improvement Lead

This is a fully remote position, open to applicants in United States.

📋 Description

• Independently design, execute, and oversee clinical program strategies aimed at enhancing medication adherence and proper medication use among Medicare members.

• Emphasize telehealth and in-home care delivery methods.

• Contribute to the performance of patient safety measures within Humana's Pharmacy Stars team.

• Utilize independent judgment and decision-making capabilities in addressing complex challenges.

• Assess various factors to identify the optimal course of action.

• Operate with minimal supervision.

• Engage with HireVue interviewing technology as part of the recruitment process.

• Some travel to Humana offices for training or meetings may be necessary.

⛳️ Requirements

• Bachelor’s Degree in Business, Finance, Health Care, or a related discipline.

• A minimum of 2 years of experience in project leadership.

• Prior experience in Medicare/Medicaid is essential.

• Strong strategic thinking and planning skills; highly organized and detail-oriented.

• Exceptional communication abilities.

• Demonstrates enthusiasm and motivation; acts as a confident change agent with strong oral and written presentation skills.

• Capacity to perform under tight deadlines.

• Extensive knowledge of Microsoft Office applications, including Word, Excel, and PowerPoint.

• A genuine passion for contributing to an organization dedicated to continuously enhancing consumer experiences.

• Preferred: Experience in medication prescribing and medical coding as a PA, NP, or BSN.

• Preferred: Master’s Degree in Business Administration, Health Administration, or a related field.

• Preferred: Progressive experience within the health solutions sector.

• Preferred: Experience in provider relations.

• Preferred: Previous experience in managed care.

• Preferred: Understanding of metrics, trends, and the ability to analyze and identify care gaps.

• Preferred: Proven organizational and prioritization abilities, along with collaboration skills across multiple departments.

• Preferred: Familiarity with CMS Stars and performance metrics.

• Preferred: Knowledge and experience with HEDIS.

• Preferred: Background in quality improvement initiatives.

• Minimum required download speed of 25 Mbps and upload speed of 10 Mbps for self-provided internet service.

• Capability to work from a dedicated space without distractions to safeguard member PHI/HIPAA information.

🏝️ Benefits

• Bonus incentive plan based on individual and/or company performance.

• Comprehensive medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Telephone equipment suitable for business needs.

• Bi-weekly internet expense reimbursement for employees residing and working from home in California, Illinois, Montana, or South Dakota.