Location: Remote (U.S.-Based)
Travel: Up to 50%

Shape the Future of Medicare Advantage Performance

Health plans today face unprecedented challenges, including evolving CMS regulations, increasing pressure to improve quality outcomes, rising member expectations, and tighter financial margins.

At Press Ganey, we help health plans navigate these complexities and achieve measurable results. Through industry-leading expertise in quality, member experience, analytics, and regulatory performance, we partner with organizations to improve Star Ratings, optimize member outcomes, enhance operational effectiveness, and drive sustainable growth.

We are seeking a Consultant to join our Stars Consulting Center of Excellence. This role is ideal for a Medicare Advantage professional who combines strong analytical capabilities with deep knowledge of Stars performance and regulatory quality programs. You will work directly with health plan leaders to identify opportunities, solve complex challenges, and deliver strategies that improve performance across the most critical quality measures.

What You'll Do

As a Senior Consultant, you will serve as a trusted advisor to health plans, helping clients improve quality performance and achieve strategic objectives.

Key Responsibilities

• Lead consulting engagements focused on Medicare Stars and regulatory performance improvement.
• Analyze and interpret data across HEDIS, CAHPS, HOS, Part D, operational measures, and Special Needs Plans (SNPs).
• Conduct performance assessments, measure trending, gap analyses, cut-point modeling, and root cause analyses.
• Develop executive-level recommendations and actionable improvement strategies based on data insights.
• Partner with health plan and medical group stakeholders to identify opportunities for quality, experience, and operational improvement.
• Design and facilitate workshops, training sessions, and process improvement initiatives.
• Manage project plans, timelines, deliverables, budgets, and engagement outcomes.
• Build strong client relationships and serve as a primary point of contact throughout engagements.
• Monitor CMS guidance, regulatory requirements, and technical specification updates, translating changes into meaningful client recommendations.
• Collaborate with cross-functional teams to integrate Stars consulting strategies with analytics, CAHPS, HOS, and member experience solutions.

Areas of Consulting Impact

Stars Center of Excellence

Provide end-to-end consulting support across HEDIS, CAHPS, HOS, Part D, and SNPs, helping health plans improve performance, close quality gaps, enhance member outcomes, and maximize Star Ratings.

Regulatory Readiness

Guide clients through evolving CMS and state requirements by conducting readiness assessments, simulations, and strategic planning initiatives aligned to quality, compliance, and Stars performance goals.

Performance Stabilization & Transformation

Support organizations during critical business transitions, including M&A integrations, organizational restructuring, and SNP launches, through governance design, stakeholder alignment, quality program optimization, and sustainable performance improvement strategies.

Qualifications
Required

• 2+ years of experience in health plan quality, Medicare Stars, healthcare consulting, experience management, or performance improvement.
• Hands-on experience supporting Dual/SNP and MA Star Ratings performance.
• Knowledge of one or more quality domains, including HEDIS, CAHPS, HOS, Part D, medication adherence, or quality operations.
• Strong analytical and problem-solving skills with experience using Excel, Access, SQL, SAS, or similar tools.
• Demonstrated success driving measurable quality or performance improvement initiatives.
• Exceptional written, verbal, and presentation skills.
• Ability to influence stakeholders and communicate effectively with executive audiences.
• Advanced proficiency in Microsoft Office Suite, particularly Excel and PowerPoint.
• Strong project management and organizational skills.
• Bachelor's degree required.

Why Press Ganey?

This is an opportunity to join a high-impact consulting team that helps some of the nation's leading health plans improve quality, elevate member experience, and achieve stronger business results. You'll work on meaningful challenges, collaborate with industry experts, and directly influence the performance of programs that serve millions of Medicare beneficiaries.

If you're passionate about Medicare Advantage quality and want to help shape the future of Stars performance, we'd like to hear from you.

Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Press Ganey we are dedicated to building a diverse, inclusive and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.