Medicare Advantage Quality Consultant - Registered Nurse (Western, PA)
Highmark Health(1 month ago)
About this role
A Medicare Advantage Quality Consultant at Highmark is a subject matter expert in Medicare STARS, Medicaid HEDIS, and risk revenue streams focused on driving value creation and meeting fiscal/ROI targets for government value-based programs. The role partners with primary care providers and internal stakeholders to analyze performance data and develop strategic plans that improve outcomes. It emphasizes transformation of practice workflows and continuous improvement to achieve exemplary program performance.
Required Skills
- Medicare STARS
- Medicaid HEDIS
- Risk Revenue
- Data Analysis
- Population Health
- Provider Engagement
- Chart Reviews
- Strategic Planning
- Performance Improvement
- Communication
+3 more
Qualifications
- Bachelor's Degree in Clinical or Healthcare Field
- Master's Degree in Clinical or Healthcare Field
- Registered Nurse (RN)
About Highmark Health
highmarkhealth.orgA national health and wellness organization as well as the second largest integrated delivery and financing system in America.
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