Providence

Compensation

Full Description

Description: • 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: • retirement 401(k) Savings Plan with employer matching • health care benefits (medical, dental, vision) • life insurance • disability insurance • time off benefits (paid parental leave, vacations, holidays, health issues) • voluntary benefits • well-being resources