Key skills
LeadershipCommunicationPresentation Skills
About this role
Role Overview
- Develops, implements, and provides oversight on the execution of the regional markets Medicare/Medicaid Stars quality improvement programs and initiatives
- Work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors to recommend, manage and execute strategies to improve overall Star ratings and provider engagement
- Develops programs designed to increase the plans overall Star ratings and improve quality outcomes
- Partners with leaders regarding implementation planning
- Reviews and communicates results of programs
- Influences department’s strategy
- Makes decisions on moderately complex to complex issues regarding technical approach for project components, with considerable latitude in determining objectives and approaches to assignments
Requirements
- Experience with Medicare and/or managed care
- Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system
- Understanding of and ability to drive interoperability
- Understanding of Consumer/Patient Experience
- Experience building relationships with physician groups and influencing execution of recommended strategy
- Strong communication and presentation skills, both verbal and written, and experience presenting to internal and external customers, including high-level leadership
- Experience with focus on process and quality improvement
- Understanding of metrics, trends and the ability to identify gaps in care
- Comprehensive knowledge of all Microsoft Office Word, Excel and PowerPoint
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- many other opportunities