AVP Stars and Risk Adjustment National Medical Director
Location
Overland Park, KS, United States
Employment Type
Full-Time
Posted on
Apr 28, 2023
Apply for this job
your email:
upload resume:
Profile
Job Information
Humana
AVP, Stars and Risk Adjustment National Medical Director
in
Overland Park
Kansas
Description
The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can contribute to Humana's national planning and operations for Risk Adjustment, Stars, and Interoperability. Specifically, this role will carry a set of individual contributor and leadership responsibilities.
As an individual contributor, this role will: 1) inform and support HQRI's provider strategy across Stars, RA, and Interoperability, 2) serve as a coding expert to manage escalations or establish compliant policies, and 3) contribute as a clinical industry representative.
As a leader, this role leads HQRI's Provider Support team (PST) that drives national provider education strategy and operations along with provider communication operations.
HQRI is an organization with over 900 associates that leads Humana'sStars, Risk Adjustment and Interoperability strategy, operations, and performance nationally.
This role relies on medical background, business acumen, and industry-standard clinical / coding guidance to ensure physician and healthcare provider plans, education, reporting and materials are accurate and consistent across the enterprise to support regional and corporate strategic initiatives.
Responsibilities
The Associate Vice President (AVP), Stars and Risk Adjustment National Medical Director leads key strategic and operational functions. In collaboration with corporate stakeholders and regional teams, this role is responsible for supporting corporate and regional strategies for physician and healthcare provider education or operations for Risk Adjustment and Stars. In addition, the position provides supportive clinical and coding expertise across the teams in HQRI. Lastly, this leader will be instrumental in supporting interoperability efforts. This position reports the Vice President of Strategy Advancement in the Healthcare Quality Reporting and Improvement organization (HQRI) and collaborates significantly with the HQRI Senior Leadership Team across its programs.
This is a remote position with travel expectations up to 25%.
Major responsibilities include
Inform HQRI's provider strategy and increase adoption of Humana's Stars, MRA, and interoperability strategy and programs
Lead a team/organization of 10 associates across three functions: Education of Humana's Market-based associates on how to drive accurate reporting through provider education; Provider communications; policies and procedures aligned to those functions
Serve as HQRIs clinical industry representative (e.g., Conferences; national vendor or provider partners)
Serve as a coding expert, which may include working through escalations on coding disputes, policy development or refinement, and coordination and education with providers or Humana associates
Required Qualifications
MD or DO degree
A current and unrestricted license in at least one jurisdiction
Board Certified in an approved ABMS Medical Specialty
Excellent communication skills, both written and verbal
5 years of established clinical experience
Knowledge of the managed care industry including Medicare, Medicaid and / or Commercial products
Must be passionate about healthcare quality and contributing to an organization focused on maintaining accuracy of coding and documentation to capture the true health status of our members thru risk adjustment initiatives
Experience with quality assurance and/or regulatory compliance
Travel up to 25%
Preferred Qualifications:
Certification in diagnosis coding (must receive AAPC certification within one year of hire)
Ability to help develop and use data and analytics to drive sustainable results
External communications for physicians and healthcare providers
Prior experience leading teams focusing on the accuracy of medical record documentation and diagnosis coding
Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.
Working knowledge of risk adjustment concepts
Internal Medicine, Family Practice, Geriatrics, OBGYN, Hospitalist clinical specialty
Detail oriented and effective listener
Experience with Stars, including HEDIS, CAHPS and HOS
Prior experience in a business function or business consulting role
Additional Information:
Vaccine Policy
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters.
Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field
Scheduled Weekly Hours
40
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 ***/legal/accessibility-resources?source=Humana_Website.
Humana Inc.
Website :
***
DescriptionHumana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we.
•
United States - KS - KS - Troy
June 23, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Fontana
June 23, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Pleasanton
June 27, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Overland Park
June 23, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
Twin Oaks Health and Rehab Operations LLC
United States - KS - KS - Lansing
June 30, 2024
Job Summary • The Dietary Aide assists in the kitchen area prior to, during and after meals are served. Assists in maintaining kitchen work areas; keeping equipment, utensils and food plates clean and orderly. • Duties and Responsibilities: • Comply with the Facility's personnel, safety, and...
United States - KS - KS - Nortonville
June 27, 2024
Now Hiring Company Drivers in Your Area! • Family Owned, Guaranteed Freight + Guaranteed Weekly Home Time • Benefits: • Kansas City Drivers: Average driver can earn $91K. Top Drivers can earn $97,500 • Paid hourly for ALL time spent loading/unloading • New equipment |...
United States - KS - KS - Fort Leavenworth
June 27, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
Haysville Nursing and Rehab Center
United States - KS - KS - Haysville
June 30, 2024
Overview: • NEW Pay Wages! Diversicare of Haysville is Great Place to Work certified! • At Diversicare, we value our team members and provide opportunities for growth and career advancement. • Our Nurses are fundamental to our mission of improving every life we touch by providing...
United States - KS - KS - Hillsdale
June 27, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Augusta
June 18, 2024
• As overseers of electricity, Interior Electricians are valuable to the operations of the Army National Guard. They're the Soldiers who light the way for their crews by installing and repairing wire systems in offices, repair shops, airplane hangars, and other buildings. • As an Interior...
United States - KS - KS - Auburn
June 27, 2024
Now Hiring Company Drivers in Your Area! • Family Owned, Guaranteed Freight + Guaranteed Weekly Home Time • Benefits: • Kansas City Drivers: Average driver can earn $91K. Top Drivers can earn $97,500 • Paid hourly for ALL time spent loading/unloading • New equipment |...
United States - KS - KS - Osawatomie
June 27, 2024
Now Hiring Company Drivers in Your Area! • Family Owned, Guaranteed Freight + Guaranteed Weekly Home Time • Benefits: • Kansas City Drivers: Average driver can earn $91K. Top Drivers can earn $97,500 • Paid hourly for ALL time spent loading/unloading • New equipment |...
United States - KS - KS - Ozawkie
June 23, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Lecompton
June 27, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Wichita
June 18, 2024
• The Army National Guard relies on Soldiers to test and maintain electrical systems for its ground weapons systems. As an Artillery Mechanic in the Army National Guard, you will supervise and perform maintenance on all self-propelled field artillery cannon weapon systems, including automotive,...
United States - KS - KS - Winchester
June 27, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Wichita
May 14, 2024
TravelNurseSource is working with Host Healthcare to find a qualified PICU RN in Wichita, Kansas, 67214! • Pay Information • $1,464 to $1,614 per week • About The Position • Host Healthcare is an award-winning travel healthcare company with an immediate opening for this Registered Nurse - PICU in...
United States - KS - KS - Kansas City
June 29, 2024
TRUCK DRIVING JOBS: WE ARE HIRING DRIVERS! We're a Certified Top Pay Carrier and • the top 50 percent of our drivers • average$90,518 per year. STRONGER TOGETHER • It s part of the American fabric. Good people getting a job done. Customers facing deadlines. Drivers delivering safely and on time. And...
United States - KS - KS - Garden City
June 30, 2024
KPG Allied is seeking a travel Radiology Technologist for a travel job in Garden City, Kansas. & Requirements • Specialty: Radiology Technologist • Discipline: Allied Health Professional • Start Date: ASAP • Duration: 13 weeks • 40 hours per week • Shift: 8 hours • Employment Type: Travel •...
United States - KS - KS - Basehor
June 27, 2024
Now Hiring Company Drivers in Your Area! • Family Owned, Guaranteed Freight + Guaranteed Weekly Home Time • Benefits: • Kansas City Drivers: Average driver can earn $91K. Top Drivers can earn $97,500 • Paid hourly for ALL time spent loading/unloading • New equipment |...
United States - KS - KS - Perry
June 23, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Overland Park
June 30, 2024
At Hy-Vee our people are our strength. We promise "a helpful smile in every aisle" and those smiles can only come from a workforce that is fully engaged and committed to supporting our customers and each other. • Job Title: Checker • Department: Grocery • FLSA: Non-Exempt • General Function: • As a...
United States - KS - KS - Quenemo
June 26, 2024
Now Hiring Company Drivers in Your Area! • Family Owned, Guaranteed Freight + Guaranteed Weekly Home Time • Benefits: • Kansas City Drivers: Average driver can earn $91K. Top Drivers can earn $97,500 • Paid hourly for ALL time spent loading/unloading • New equipment |...
United States - KS - KS - Vassar
June 23, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Oskaloosa
June 27, 2024
ARTUR EXPRESS HAS DRY VAN DRIVER OPPORTUNITIES AVAILABLE • COMPANY DRIVER JOBS | LEASE PURCHASE OPPORTUNITIES | OWNER OPERATOR OPPORTUNITIES • Benefits: • Solo company drivers earn 0.55 - 0.60 CPM, depending on experience • 2,200 - 2,500 miles/week - drop and hook •...
United States - KS - KS - Olathe
March 28, 2024
Job Position: Forklift Operator Location: Olathe, KS 66062 Pay Rate: $22.00/hr Shift: Front Half 2nd Shift 4:30pm-3am Sunday-Wednesday We are currently seeking a Material Handler to join our team at our cold storage facility, where temperatures are maintained at 36 degrees year-round. As a Material...
United States - KS - KS - Liberal
June 30, 2024
Pay Range: • $45-$65/Hour By using the GoTu app, you can find local temporary and permanent opportunities and get peace of mind with guaranteed payment. Our platform allows hygienists to work when they want, where they want, and for how much they want. Whether you're looking to find your forever...