STARS - Medicare - Director
8 - 10 years experience • Staffing & Recruiting
Director, STARS (Medicare)
*Previous STARS experience required.
*7+ years of managed care experience needed.
*Previous Medicare management experience required.
Salary: $120K-$130K + 20% Bonus
Regional Relocation Assistance Available
Candidate will be expected to provide strategic leadership, guidance and manage the Medicare STARs across the corporations Medicare Plans.
Act as a leader and expert of Medicare Stars Program to ensure Healthcare Effectiveness Data and Information Set (HEDIS) and Stars objectives are met to support the overall goals.
Develop, manage and coordinate clinical and non-clinical HEDIS and Stars-related activities.
Integrate Stars activities with risk adjustment initiatives.
Work closely with various cross-functional teams, locations and departments to improve STARs outcomes for Medicare members.
Serve as a business resource and subject expert for health plan quality and Medicare operations teams and all internal and external business partners.
Closely follow CMS guidance and translate into business strategies and tactics.
Partner with multiple stakeholders and business unit leadership to establish operational objectives and procedures.
Perform analysis of enterprise-wide data and practices to identify opportunities for improvement at the local and national level.
Lead cross functional efforts to develop, deploy and manage reporting dashboard.
Ensure policies and procedures are compliant with NCQA and CMS guidelines.
*Bachelor's degree in Nursing, Healthcare Administration or related field. *7+ or more years of experience in managed care operations with emphasis on Medicare.
*Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
*Knowledge of Center for Medicare/Medicaid Services, requirements for Special Needs Plans (SNP), Medicare Medicaid Plans (MMP) and NCQA oversight requirements preferred.
*Project management, administration or operations experience in the healthcare industry preferred.
Equal opportunity employer that is committed to diversity, and values the ways in which we are different.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.