Business Consultant translating business needs into software requirements at Elevance Health. Responsible for analyzing, designing, and writing Business Requirement Documents in a hybrid work environment.
About the role
- Nurse Senior Stars Improvement Consultant working at Humana managing Medicare/Medicaid Quality Rating System. Collaborating with provider groups to ensure favorable outcomes for CMS Star Rating categories.
Responsibilities
- Contributes to the development, implementation, and management of the company's Medicare/Medicaid Five-Star Quality Rating System
- Works directly with provider groups, Management Services Organizations (MSOs) and organizational leaders to impact Centers for Medicare & Medicaid Services (CMS) Star Rating categories
- Focuses on areas of clinical emphasis related to the CMS Stars Program
- Relationship building and implementation of best practices to drive results within a provider network and MSO as it relates to clinical HEDIS measures
- Experience in preparing and delivering training sessions, educational materials, performance reports, and presentations
Requirements
- Licensed Professional Nurse or Registered Nurse
- 3 or more years of Medicare experience
- 3 or more years of CMS Stars and HEDIS experience
- Strong knowledge of Microsoft Office XP products (Word, Excel, PowerPoint)
- Proven analytical skills (i.e., trending and analysis of healthcare data)
Benefits
- 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
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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