Manager, STARS (Marketplace & Medicare) 8/16/2016
Fort Lauderdale, FL
JOB DESCRIPTIONAPPLY Position Purpose: Manage Medicare STARs program for the Health Plan.
* Lead efforts to maximize the Medicare CMS Star Rating and work to develop a multi-year strategy in collaboration with organizational stakeholders
* Develop performance improvement strategies, including development and analysis of reports
* Lead Member Perception workgroup, project manage initiatives and implement initiatives to improve Star ratings
* Monitor initiatives and progress in the Clinical, Pharmacy and Provider workgroups
* Work with various cross-functional teams, locations and departments to improve Star ratings
* Track and report on initiative progress at all levels of the organization; lead monthly meetings with health plans to report on plan led initiatives
* Perform analysis of enterprise-wide data and practices to identify opportunities for improvement at the local and national level
* Manage Stars reporting dashboard
Education/Experience: Bachelor's degree in Business, Healthcare Administration or related field. 4+ years of managed care operations experience with emphasis on Medicare. 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 in the Healthcare industry preferred. Strong team-building skills with the ability to drive results within cross-functional teams. Proven track record in managing multiple high-risk, high-visibility, initiatives from definition through implementation.
RN license is preferred.
Experience with clinical outcomes is preferred.
Process improvement experience is a plus.