Stars Program Delivery Lead – HEDIS Diabetes Eye Exam

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must possess a Bachelor's Degree in Business Administration, Health Administration, or a related field, with at least 7 years of experience in innovation, program delivery, or strategy. Proven skills in data trend analysis and identifying performance improvement opportunities are essential, along with HEDIS experience and strong attention to detail. Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and the ability to navigate business intelligence tools are also required.

Responsibilities

The Stars Program Delivery Lead is responsible for advancing initiative improvement strategies, operational execution, and performance oversight to achieve high condition management Stars performance targets, focusing on clinical gap closure, health outcomes, and member experience. Key duties include applying knowledge of HEDIS condition management measures to develop and implement solutions, partnering with analytics teams, engaging stakeholders, analyzing data to identify improvement opportunities, conducting audits of data collection processes, creating standard operating procedures, and supporting strategic functions with analytical thinking and problem-solving.

Skills

HEDIS

Diabetes Eye Exam

Stars Program

Quality Improvement

Data Analysis

Stakeholder Engagement

Performance Oversight

Clinical Gap Closure

Member Experience

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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