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Posted: 10/20/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in leading telephonic outreach initiatives to close care gaps and improve member health outcomes, while effectively managing team performance and compliance with Stars measures. Proficient in data analysis to identify trends and implement actionable improvement plans.
Highest-signal resume keywords
Registered Nurse LicenseCase Management ExperienceData-Driven LeadershipMicrosoft Office ProficiencyManaged Care Experience
About the role
Key responsibilities & impact- Lead associates conducting targeted telephonic outreach to help members close care gaps, identify health and social needs, and connect with resources
- Provide leadership and coaching through one-on-one meetings, team meetings, call listening, and outreach reviews
- Ensure associates identify needs beyond the initial outreach purpose and triage or refer members to clinical, social, or community resources
- Set expectations and manage performance across outreach, care-gap closure, productivity, documentation, attendance, compliance, member experience, and health outcomes
- Translate Stars priorities and measurement requirements into team actions
- Monitor results and adjust outreach strategies to improve engagement, team performance, care-gap closure, and Stars outcomes
- Collaborate with Enterprise Stars, quality, operations, analytics, and stakeholder teams
- Use performance, quality, and operational data to identify trends, risks, barriers, and coaching needs
- Implement measurable action plans to improve associate performance and Stars results
- Serve as an escalation resource for complex member needs, referrals, outreach barriers, associate concerns, and operational issues
- Communicate performance concerns, risks, barriers, and recommendations on leadership calls
- Support audit readiness and address performance or compliance concerns
- Support onboarding, training, mentoring, and ongoing education on Stars measures and care-gap workflows
- Connect daily team work to enterprise goals, member experience, and health outcomes
- Report directly to the Associate Director of Care Management
Requirements
What you’ll need- Active, unrestricted Registered Nurse license with no disciplinary action
- Compact licensure required
- 5 or more years of RN experience
- 3 or more years of experience in case management
- 1 or more years of data-driven leadership experience, including analyzing performance, identifying trends and risks, and implementing measurable improvement plans
- Strong computer proficiency in Microsoft Office programs
- Demonstrated ability to learn and navigate multiple software applications
- Preferred: Bachelor’s or Master’s degree in nursing, healthcare administration, business, or a related field
- Preferred: Three or more years of management or supervisory experience
- Preferred: Previous experience in managed care, Medicare Stars, quality improvement, telephonic member outreach, care-gap closure, or related member engagement programs
- Effective communication and interpersonal skills
- Strong organizational and time-management skills
- Solid problem-solving and decision-making skills
- Ability to embrace ambiguity and change
- Ability to manage competing priorities and adapt quickly in a fast-paced environment
- Home internet with at least 25 Mbps download and 10 Mbps upload speed
- Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information
- Florida applicants from a Florida work location must complete Florida Level 2 background screening
Benefits
Comp & perks- Bonus incentive plan based on company and/or individual performance
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Occasional travel to Humana offices for training or meetings
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care-Gap ClosurePerformance AnalysisQuality ImprovementTelephonic OutreachMember Engagement Programs
Soft Skills
Effective CommunicationInterpersonal SkillsOrganizational SkillsProblem-Solving SkillsTime-Management Skills
Tools & Technologies
Multiple Software ApplicationsPerformance Data Tools
Certifications & Qualifications
Active Registered Nurse LicenseCompact Licensure
Industry Keywords
Medicare StarsComplianceHealth OutcomesAudit ReadinessFlorida Level 2 Background Screening