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AVP Stars and Risk Adjustment National Medical Director
Location : Newport, RI, United States
Posted on : Apr 28, 2023
Profile
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. This role will carry a set of individual contributor and leadership responsibilities.
Responsibilities
- 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 accurate reporting through provider education; Provider communications; policies and procedures aligned to those functions.
- Serve as HQRI's 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
Preferred Qualifications
Additional Information
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.
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