Associate Principal, Stars Consulting Center – Excellence

This is a fully remote position, open to applicants in Texas.

📋 Description

• Lead and personally execute Medicare Stars consulting projects focusing on CAHPS, HEDIS, HOS, medication adherence, and operational performance metrics.

• Act as the firm's subject matter expert on HEDIS methodologies, measure specifications, reporting, supplemental data strategies, and optimizing medical record reviews.

• Convert CMS regulations, rate announcements, technical specifications, and updates on Stars methodology into actionable client strategies.

• Perform measure-level analyses and formulate recommendations aimed at enhancing quality and Stars performance.

• Create executive presentations, strategic roadmaps, dashboards, client reports, and improvement playbooks.

• Oversee multiple high-priority client projects, ensuring outstanding service delivery and measurable results.

• Counsel health plan executives and operational leaders, promote organizational alignment, and foster long-term client relationships.

• Discover opportunities to incorporate Press Ganey solutions, such as Hyperlift analytics, CAHPS, and HOS offerings.

• Spearhead scope development, proposal generation, pricing strategies, and solution design for new projects.

• Contribute to revenue growth, industry thought leadership, conferences, publications, and market-facing content.

• Mentor, coach, and cross-train consultants in Stars performance domains.

• Assist in methodology development and the sharing of best practices within the consulting organization.

⛳️ Requirements

• Over 10 years of experience in government-funded healthcare, encompassing Medicare Advantage and/or Medicaid.

• Direct responsibility for Medicare Star Ratings, quality improvement, population health, or regulatory performance initiatives.

• Proven success in advising executive leaders on healthcare quality, Stars, and operational performance strategies.

• Experience in leading complex, cross-functional initiatives that deliver measurable business outcomes.

• Bachelor's degree is required.

• Extensive knowledge of HEDIS, including NCQA measure specifications, claims data, supplemental data, ECDS reporting, audit processes, and performance improvement strategies.

• Strong grasp of Medicare Star Ratings methodology, covering measure weighting, cut point movements, improvement measures, Categorical Adjustment Index, reward factors, and Quality Bonus Payment implications.

• Experience in analyzing performance data and pinpointing opportunities to enhance measure outcomes.

• Proficiency in Excel, SQL, and/or other analytics tools for conducting measure-level performance analyses.

• Advanced skills in Microsoft Office, especially PowerPoint and Excel.

• Exceptional communication, facilitation, presentation, and consulting skills tailored for executive audiences.

• Demonstrated ability to influence senior stakeholders and steer strategic decision-making.

• Strong analytical, quantitative, and problem-solving skills.

• Capacity to excel in a fast-paced, client-facing consulting environment.

• In-depth understanding of Medicare Advantage market dynamics, quality measurement, and changing regulatory requirements.

• Willingness to travel up to 75%.

🏝️ Benefits

• Competitive benefits package.

• Discretionary bonus or commission based on results achieved.

• Reasonable accommodations for qualified individuals with disabilities or disabled veterans.

• Equal Employment Opportunity/Affirmative Action workplace.

• Diverse, inclusive, and authentic workplace.