Consultant, Medicare Stars – Regulatory Performance Improvement

Press Ganey

Medicare Stars consultant helping Press Ganey, a healthcare analytics and experience measurement provider, improve health plan quality and regulatory performance. Advising health plans through data analysis, readiness assessments, and transformation initiatives.

Posted 8/5/2026full-timeRemote • California, Illinois, New York, Texas • 🇺🇸 United StatesJuniorMid-Level💰 $90,000 - $125,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicare Stars consulting, focusing on performance improvement and regulatory compliance. Proficient in data analysis across HEDIS, CAHPS, HOS, and Part D, with strong project management and stakeholder engagement capabilities.

Highest-signal resume keywords

Medicare Stars ConsultingHEDIS AnalysisPerformance ImprovementProject ManagementStakeholder Engagement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisPerformance AssessmentGap AnalysisCut-Point ModelingRoot Cause AnalysisQuality OperationsMedication AdherenceExcelSQLSAS

Soft Skills

Analytical SkillsProblem-Solving SkillsWritten CommunicationVerbal CommunicationPresentation Skills

Tools & Technologies

Microsoft Office SuiteExcelPowerPointAccess

Industry Keywords

MedicareDual/SNPMA Star RatingsCMS GuidanceQuality ImprovementOperational MeasuresSpecial Needs Plans

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Lead consulting engagements focused on Medicare Stars and regulatory performance improvement
Analyze and interpret data across HEDIS, CAHPS, HOS, Part D, operational measures, and Special Needs Plans (SNPs)
Conduct performance assessments, measure trending, gap analyses, cut-point modeling, and root cause analyses
Develop executive-level recommendations and actionable improvement strategies based on data insights
Partner with health plan and medical group stakeholders to identify quality, experience, and operational improvement opportunities
Design and facilitate workshops, training sessions, and process improvement initiatives
Manage project plans, timelines, deliverables, budgets, and engagement outcomes
Build client relationships and serve as a primary point of contact throughout engagements
Monitor CMS guidance, regulatory requirements, and technical specification updates and translate changes into client recommendations
Collaborate with cross-functional teams to integrate Stars consulting strategies with analytics, CAHPS, HOS, and member experience solutions
Provide consulting support across HEDIS, CAHPS, HOS, Part D, and SNPs
Guide clients through CMS and state requirements using readiness assessments, simulations, and strategic planning
Support M&A integrations, organizational restructuring, and SNP launches through governance design, stakeholder alignment, quality program optimization, and performance improvement strategies

Requirements

What you’ll need

2+ years of experience in health plan quality, Medicare Stars, healthcare consulting, experience management, or performance improvement
Hands-on experience supporting Dual/SNP and MA Star Ratings performance
Knowledge of one or more quality domains, including HEDIS, CAHPS, HOS, Part D, medication adherence, or quality operations
Strong analytical and problem-solving skills with experience using Excel, Access, SQL, SAS, or similar tools
Demonstrated success driving measurable quality or performance improvement initiatives
Exceptional written, verbal, and presentation skills
Ability to influence stakeholders and communicate effectively with executive audiences
Advanced proficiency in Microsoft Office Suite, particularly Excel and PowerPoint
Strong project management and organizational skills
Bachelor's degree required
U.S.-based work location

Benefits

Comp & perks

Competitive benefits package
Discretionary bonus or commission tied to achieved results
Remote work arrangement for U.S.-based employees
Reasonable accommodations for qualified individuals with disabilities or disabled veterans