Join CenterWell Senior Primary Care as a Quality RN, where you'll lead initiatives that enhance patient outcomes and improve quality of care for seniors. Your expertise will directly impact the effectiveness of our Medicare/Medicaid Stars Program.
Key Responsibilities
Develop, implement, and manage oversight of the Medicare/Medicaid Stars Program
Collaborate with market leadership and quality improvement team to enhance patient outcomes
Represent the scope of provider relationships in quality/clinical management and population health
Oversee HEDIS and Stars performance and operational improvements
Manage financial performance and incentive programs
Facilitate data sharing and connectivity
Ensure proper documentation and coding
Required Qualifications
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
Strong attention to detail with a focus on process and quality
Comprehensive knowledge of Microsoft Office applications
Preferred Qualifications
Bachelor’s Degree in Nursing
3+ years of managed care experience
3+ years of case management experience
Bilingual; English and Spanish preferred, not required
Benefits & Perks
Medical, dental and vision benefits401(k) retirement savings planPaid time off, including company and personal holidaysVolunteer time offPaid parental and caregiver leaveShort-term and long-term disabilityLife insurance