Medicare STARS Program Manager

The Medicare STARS Program Manager plays a crucial role in the Quality Department at CenCal Health, which is dedicated to enhancing the quality of care for its members. This position is responsible for leading the evolution of CenCal Health's managed care systems to optimize quality as measured by the Centers for Medicare and Medicaid Services (CMS) 5 STAR Rating System. Reporting directly to the Executive Quality and Population Health Officer, the Medicare STARS Program Manager is tasked with strategically optimizing operational initiatives across the organization to maximize the Duals Special Needs Plan (D-SNP) STAR ratings and elevate the governance of the Medicare STAR Rating Program. As a subject matter expert (SME) in the regulations governing the CMS Medicare D-SNP STAR Rating System, the Medicare STARS Program Manager will provide strategic guidance and support to various stakeholders within the organization. This role requires a deep understanding of the complexities of the STAR Rating Program and the ability to communicate its requirements effectively across the enterprise. The successful candidate will collaborate with cross-functional teams to drive systems improvement, ensuring that operational excellence aligns with the goals of achieving exceptional member experiences and outcomes. Key responsibilities include developing strategic objectives for the STAR Rating Program, optimizing the use of vendor applications, monitoring performance, and ensuring compliance with CMS requirements. The Medicare STARS Program Manager will also oversee the preparation and filing of measures included in the STAR Rating Program, maintain accurate reporting, and support the development of auditing and monitoring activities to ensure data integrity. Additionally, this role involves training staff, facilitating stakeholder meetings, and promoting alignment of organizational processes with D-SNP STAR Rating Program requirements.