Senior STARS Consultant

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

📋 Description

• Act as the functional intermediary between the Intake team and the operations teams.

• Assist with business initiatives related to Medicare and Star Ratings.

• Evaluate project scope.

• Address business requirements throughout the delivery process.

• Oversee production and/or system change requests to fulfill enterprise objectives.

• Investigate and assess business impacts in relation to project scope.

• Facilitate efficient project delivery for medium-complexity initiatives that involve various business functions.

• Ensure effective communication of changes, enhancements, and operational updates to affected business units.

• Contribute to successful implementation and favorable business outcomes.

⛳️ Requirements

• A bachelor's degree is required.

• A minimum of 5 years of experience in the healthcare industry or health insurance sector.

• Prior experience with Medicare is necessary.

• Excellent written and verbal communication skills.

• Strong organizational abilities, including the capacity to prioritize tasks effectively.

• Proficient presentation skills and executive presence.

• Proven experience in engaging successfully with senior management and personnel at all levels across various departments.

• Strong analytical and problem-solving capabilities.

• Demonstrated business acumen and skills in project/program management.

• Sponsorship is not available for this position.

• Preferred: Proven experience in supporting or leading Medicare Advantage Star Ratings initiatives with quantifiable quality improvement results.

• Preferred: Comprehensive understanding of HEDIS measures, quality reporting methodologies, and strategies to enhance Star Ratings performance.

• Preferred: Extensive knowledge of Medicare Advantage products, CMS regulations, and the Medicare regulatory framework.

• Preferred: Experience with dashboards, scorecards, and performance reporting tools to identify trends, gaps, and potential interventions.

• Preferred: Familiarity with Inovalon, Cotiviti, or other quality measurement and HEDIS platforms.

• Preferred: An MBA, MPH, MHA, or related master’s degree with proven analytical, strategic, and problem-solving skills.

• Preferred: Experience in supporting healthcare quality, operational, and performance improvement initiatives.

• Preferred: Working knowledge of SQL and methodologies for healthcare data analysis.

• Preferred: Experience in vendor oversight and management.

🏝️ Benefits

• Customized development plans that foster professional growth and career advancement.

• Comprehensive health and wellness benefits.

• 401(k) savings plan.

• Pension plan.

• Paid time off.

• Paid parental leave.

• Disability insurance coverage.

• Supplemental life insurance options.

• Employee assistance program.

• Paid holidays.

• Tuition reimbursement opportunities.

• Annual incentive bonus plan subject to plan terms and conditions.

• Additional incentives available.