STARS Improvement RN

Company: Conviva Senior Primary Care
Location: San Antonio
Posted on: May 23, 2025

Job Description:

Become a part of our caring community and help us put health firstThe Stars Improvement, Clinical Professional 2 responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Stars Improvement Clinical Professional (RN) collaborates with market leadership, and quality improvement team to develop and implement programs designed to increase patient outcomes. Work is performed within the associate's assigned center locations and in collaboration with existing Quality Improvement Coordinators and Professionals and in close partnership with market and center teams.The Stars Improvement, Clinical Professional (RN) represents the scope of provider relationships across the following areas:

• Quality/clinical management and population health
• HEDIS and Stars performance
• Operational improvements
• Financial performance and incentive programs
• Data sharing and connectivity
• Documentation and coding
• Additional areas related to provider performance, member experience, market growth, provider experience and operational excellenceRequired QualificationsUse your skills to make an impact
  • Licensed Registered Nurse (RN) without restriction in applicable state
  • 5+ years of clinical nursing experience
  • Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement
  • Strong knowledge of HEDIS/Stars/CMS
  • 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
  • Comprehensive knowledge of Microsoft Office applicationsPreferred Qualification
    • Bachelor's Degree in Nursing
    • 3+ years of managed care experience
    • 3+ years of case management experience
    • Bilingual; English and Spanish preferred, not requiredAdditional Information
      • Hours for the role are: Monday-Friday 8am-5pm local time zone
      • This role is based within the provider office with regular rotation through each center within the assigned territory.
      • Tuberculosis (TB) screening: This role is considered member facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
      • Driver's License, Reliable Transportation, Insurance This role is part of Humana's Driver safety program and therefore requires an individual to have:
      • a valid state driver's license,
      • carry insurance in accordance with the state minimum required limits, or $25,000/$25,000/10,000 whichever is higher
      • and a reliable vehicle.Scheduled Weekly Hours40Pay RangeThe 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.$71,100 - $97,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description Of BenefitsHumana, 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 UsAbout Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.Equal Opportunity EmployerIt 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.

Keywords: Conviva Senior Primary Care, San Marcos , STARS Improvement RN, Healthcare , San Antonio, Texas