Senior STARS Consultant - Remote
About The Position
This position serves as the functional liaison between the Intake team and operations teams, supporting Medicare, and Star Ratings related business initiatives. Responsibilities include reviewing project scope, supporting business needs throughout the delivery cycle, and managing production and/or system change requests to deliver enterprise initiatives. The role researches and analyzes business impacts against project scope and supports effective project delivery for medium-complexity initiatives that may span multiple business functions. Additionally, the position facilitates communication of changes, enhancements, and operational updates to impacted business units to support successful implementation and business outcomes.
Requirements
- Bachelor’s degree
- 5 years of healthcare industry or health insurance work experience
- Previous experience with Medicare
- Strong written and oral communication skills
- Organizational skills, including ability to prioritize tasks
- Presentation skills and executive presence
- Experience with interacting successfully with senior management and staff of all levels across multiple departments
- Analytical thinking, and problem-solving skills
- Business acumen and project / program management skills
Nice To Haves
- Demonstrated experience supporting or leading Medicare Advantage Star Ratings initiatives with measurable quality improvement outcomes.
- Deep understanding of HEDIS measures, quality reporting methodologies, and strategies used to improve Star Ratings performance.
- In-depth knowledge of Medicare Advantage products, CMS regulations, and the Medicare regulatory environment.
- Experience utilizing dashboards, scorecards, and performance reporting tools to identify trends, gaps, and opportunities for intervention.
- Experience with Inovalon, Cotiviti, or other quality measurement and HEDIS platforms.
- MBA, MPH, MHA, or related master's degree with demonstrated analytical, strategic, and problem-solving capabilities.
- Experience supporting healthcare quality, operational, and performance improvement initiatives.
- Working knowledge of SQL and healthcare data analysis methodologies.
- Vendor oversight and management experience.
Responsibilities
- Reviewing project scope
- Supporting business needs throughout the delivery cycle
- Managing production and/or system change requests to deliver enterprise initiatives
- Researching and analyzing business impacts against project scope
- Supporting effective project delivery for medium-complexity initiatives that may span multiple business functions
- Facilitating communication of changes, enhancements, and operational updates to impacted business units to support successful implementation and business outcomes
Benefits
- health and wellness benefits
- 401(k) savings plan
- pension plan
- paid time off
- paid parental leave
- disability insurance
- supplemental life insurance
- employee assistance program
- paid holidays
- tuition reimbursement
- other incentives
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
