Quality Program Manager – Health Plan Medicare Advantage Stars
Providence
Quality Program Manager – Health Plan Medicare Advantage Stars
Providence
full-time
Posted on:
Location Type: Remote
Location: Remote • Oregon, Washington • 🇺🇸 United States
Visit company websiteSalary
💰 $42,080 - $73,040 per year
Job Level
Mid-LevelSenior
About the role
- Develop and implement best-practice interventions to improve Medicare Advantage Star Ratings, driving clinical quality indicators (HEDIS Star metrics), CAHPS, and HOS efforts.
- Utilize reports and dashboards to identify and socialize Star rating trends, gaps, and areas for improvement and use the data to develop action and monitoring plans.
- Collaborate with various health plan departments (care management, customer service, outreach, product, sales, marketing, etc.) to develop and implement best-practice Stars initiatives that result in improved ratings.
- Ensure compliance with CMS Stars deliverables (e.g.: plan previews, final HEDIS, CAHPS, HOS results) and keep abreast of changes affecting Star Ratings (e.g.: measure changes, weights, cut points).
- Monitor and report on Stars program performance, delivering insights, interventions, impact to workgroups, committees, executives.
- Develop and manage relationships with external partners, stakeholders, vendors involved in Stars initiatives.
- Demonstrate strong project management skills, capable of organizing, facilitating, and managing multiple projects and programs simultaneously.
- Fully understand health plan operations and levers that result in Medicare Advantage Stars improvement.
Requirements
- Bachelor's Degree -OR- Master's Degree in Public Health, Business Administration, Health Science, Health Services Administration, or other healthcare or business-related field -OR- a combination of equivalent education and work experience
- 3 or more years of related experience working in, or with a managed care organization or clinical setting in a managed care environment
- 3 or more years of experience in project management or program management
- Demonstrated experience in program planning, development, and evaluation
Benefits
- Health care benefits (medical, dental, vision)
- 401(k) Savings Plan with employer matching
- Life insurance
- Disability insurance
- Time off benefits (paid parental leave, vacations, holidays, health issues)
- Voluntary benefits
- Well-being resources
- Comprehensive benefits package
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
Medicare Advantage Star RatingsHEDIS Star metricsCAHPSHOSdata analysisproject managementprogram planningprogram developmentprogram evaluation
Soft skills
collaborationcommunicationorganizational skillsrelationship managementfacilitationinsight delivery
