Nurse Medical Management I (Bilingual)

Company: Conviva Senior Primary Care
Location: Fort Lauderdale
Posted on: May 1, 2025

Job Description:

Become a part of our caring community and help us put health first

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The Stars Improvement, Clinical Professional (RN) is responsible for the development, implementation and management oversight of the Primary Care Organization's Stars Program in the South Florida market. The Stars Improvement, Clinical Professional (RN) works assignments involving moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. -

T he Stars Improvement Clinical Professional (RN):
Collaborates with market leadership , and quality improvement team to develop and implement programs designed to increase the patient outcomes .
W ork 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 . - -
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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 -
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 excellence -

Licensed Registered Nurse (RN) without restriction in Florida
-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 -
- 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 applications -

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Bachelor's D egree in Nursing
-3+ years of managed care experience -
-3+ years of case management experience - Bilingual; English and Spanish or Creole pre ferred, not required -

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- 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. -


The 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. This incentive opportunity is based upon company and/or individual performance.
Humana, 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 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.
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. 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.
It 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, Fort Lauderdale , Nurse Medical Management I (Bilingual), Healthcare , Fort Lauderdale, Florida