The
Manager, Government Markets Stars is responsible for leading a team dedicated to improving and maximizing Medicare Star Ratings through strategic planning, operational execution, data analytics, and cross-functional collaboration. This people leader oversees the development and implementation of Stars optimization initiatives, drives performance improvement strategies, and ensures alignment with organizational goals, regulatory requirements, and financial objectives. The role partners closely with internal stakeholders, providers, and external organizations to influence quality outcomes, enhance member experience, and improve overall plan performance. The Manager provides leadership, coaching, and performance management for team members while overseeing complex projects, budgets, reporting, and compliance activities that have significant impact on Government Markets business results and Medicare Star Ratings success.
Responsibilities:- Manage efforts to maximize Star Ratings in collaboration with organizational stakeholders. Develops performance improvement strategies, including development and analysis of reports.
• Manage the Stars team by developing policies and procedures, reviewing and prioritizing work, assigning tasks, and monitoring performance against goals
• Manage the team implementation of new initiatives to improve Star ratings.
• Provide feedback on Stars reporting dashboards, data analytical activities supporting Stars Optimization.
• Manage and lead multiple initiatives and cross functional stakeholder engagement.
• Actively collaborate with external entities CMS, BCBSA, ACO and provider communities.
• Actively engage/lead in various strategic and innovative program development to influence star ratings, risk accuracy and overall plan performance.
• Work with Government Markets (GM) financial data sets and budgets to produce budgets, cost/benefit analyses, ROI analyses, financial reporting, and other types of reporting and analyses related to Stars initiatives.
• Evaluates, plans, and designs project budget and timelines for complex projects assigned by management.
• Assesses business plans financial impact statements and implements appropriate solutions where needed.
• Evaluates business outcomes and monitors work solutions from financial and compliance perspectives.
• Assures that new procedures are implemented and understood by staff and external departments that may be affected.
Qualifications:• Bachelor's degree in business or healthcare related field or equivalent experience.
• Minimum 8 years' prior related experience
• Three (3) years management experience preferred.
• Considerable knowledge of compliance and audit practices, specifically those related to Medicare plans.
• Considerable knowledge of Medicare, CMS, Stars Technical Specifications
• Demonstrated ability to define business solutions, make decisions, identify problems, coordinate resources and implement changes.
• Must be detail oriented and understand corporate objectives. Ability to follow through on project life cycle while maintaining target deadlines.
• Must be able to work independently on projects and demonstrate strong and effective leadership skills.
• Must have advanced analytical and problem-solving skills.
• Understanding of Finance, Accounting, Budgeting, and forecasting preferred
• Ability to work in a multi-task environment.
• Strong technical knowledge of Microsoft office products, Tableau and SQL required.
• Advanced project and time management skills needed.
• Demonstrated strong oral and written communication skills necessary.
• Must have advanced understanding of the business environment.
• Must have in-depth knowledge of the unit's business systems.
• Ability to manage multiple projects and maintain target objectives. Projects generally are high profile with considerable impact on corporate systems and business processes.
Independence has implemented a "Hybrid" model which consists of Associates working
in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the
work must be performed in the Tri-State Area of Delaware, New Jersey or PennsylvaniaMust have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
