**Become a part of our caring community and help us put health first** The Senior Stars Improvement, Clinical Professional (RN) is responsible for the development, implementation and management oversight of the company's Medicare Stars Program in the Florida region. *Central and North Florida areas, exclude South Florida area and Panhandle. Far north Florida limit would be Jacksonville The Senior Stars Improvement Clinical Professional (RN) + Develops programs designed to increase the plan quality. + Medical records reviews will be 40% of role and 60% of role is participating in strategies that will support Humana provider specific measure care gap closure. + Partners with leaders regarding implementation planning. Reviews and communicates results of programs. + Provider non-standard supplemental data trending + Provider level HEDIS in service + Develop and implement measure specific strategies + Provider and Member outreach on focused care gap measures + EMR remote strategy for Humana provider care gap closure on targeted measures + Provider office in person, Zoom virtual or telephonic meetings + Weekly metrics for provider outreach may apply, some Zoom telephonic outreach will entail cold calling to the in-network providers to establish working relationships + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and incentive programs + Data sharing and connectivity, interoperability opportunities + Documentation and coding + Additional areas related to provider performance, member experience, market growth, provider experience and operational excellence In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits + And more **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) without restriction in Florida + 5 or more years of clinical nursing experience + 1 or more years of Medical Records auditing experience, in the past 5 years + 1 or more years of provider office and/ or clinic management experience, in the past 5 years + Comprehensive knowledge of Microsoft Office applications, Word and Excel with advanced knowledge of PowerPoint + Excellent presentation and communication skills, both oral and written + Strong relationship building skills as this is a provider-facing role + Strong attention to detail with a focus on process and quality + Valid driver's license with reliable transportation and the ability to travel up to 40% within the region **Preferred Qualifications** + Bachelor’s degree in Nursing + 3 or more years years of managed care experience + 3or more years years of case management experience + Working knowledge of HEDIS/Stars/CMS **Additional Information** + Hours for the role are: Monday-Friday 8am-5pm EST + **This role is remote/virtual, but candidate may travel to provider offices within region up to** **40%** **and travel to market offices within region for in person meetings** **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. $78,400 - $107,800 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. **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. **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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.