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Quality Program Manager - Medicare Advantage Stars •Virtual •

Quality Program Manager - Medicare Advantage Stars •Virtual •

ProvidenceBeaverton, OR, United States
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Quality Program Manager - Medicare Advantage Stars

The Quality Program Manager – Medicare Advantage Stars is tasked with serving as a Star Ratings Subject Matter Expert (SME) who is experienced at using Stars data, CMS Star Rating Technical Notes and HPMS memos to develop and implement best-practice strategies that result in improved Star ratings.

The Stars Quality Program Manager will :

  • Develop and implement strategies to improve Medicare Advantage Star Ratings, driving clinical quality indicators (HEDIS Star metrics), CAHPS, and HOS efforts.
  • Partner with the data analytics team to create reports and dashboards that identify and visualize Star rating trends, gaps, and areas for improvement.
  • Collaborate with various internal departments (care management, customer service, outreach, product, sales, marketing, to develop and implement best-practice Stars initiatives that result in improved ratings.
  • Ensure compliance with CMS Stars deliverables and keep abreast of regulatory changes affecting Star Ratings.
  • Monitor and report on Star program performance, delivering insights, interventions, impact to workgroups, committees, executives.
  • Develop and manage relationships with external partners and stakeholders involved in Stars initiatives.
  • Demonstrate strong project management skills, capable of organizing, facilitating, and managing multiple projects and programs simultaneously.

Providence welcomes virtual work for applicants who reside in one of the following States :

  • Washington
  • Oregon

    • Required Qualifications :

  • Bachelor's Degree -OR-
  • Master's Degree in Public Health, Business Administration, Health Science, Health Services Administration, or other healthcare or business-related field -OR- a combination of equivalent education and work experience
  • 3 or more years of related experience working in, or with a managed care organization or clinical setting in a managed care environment
  • 3 or more years of experience in project management or program management
  • Demonstrated experience in program planning, development, and evaluation

    • Preferred Qualifications :

  • Experience in quality management principles, tools, and techniques
  • 5 or more years of experience in project management or program management
  • Experience with Stars program oversight, including intervention development and implementation for clinical quality (Stars HEDIS) measures, CAHPS, HOS
  • Deep understanding of the Medicare Advantage Stars program, CMS Star Rating Technical Notes, HPMS memos, and ability to interpret, communicate, and action CMS guidance specific to the Stars program

    • Salary Range by Location :

  • Oregon : Non-Portland Service Area : Min : $42.08, Max : $65.32
  • Oregon : Portland Service Area : Min : $45.14, Max : $70.07
  • Washington : Western - Except Tukwila : Min : $47.05, Max : $73.04
  • Washington : Southwest - Olympia, Centralia : Min : $45.14, Max : $70.07
  • Washington : Clark County : Min : $45.14, Max : $70.07
  • Washington : Eastern : Min : $40.16, Max : $62.35
  • Washington : Southeastern : Min : $42.08, Max : $65.32

    • Why Join Providence?

    Our are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our of caring for everyone, especially the most vulnerable in our communities.

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    Quality Program Manager • Beaverton, OR, United States