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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.
Centene is an 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.
More Information About the Job
Is Relocation Available?
Is there a bonus structure?
Are you open to sponsorship?
This position is:
Is there a possibility to work remote?
Is there equity?
Are there flexible work hours?
Does this position have direct reports?
Who does this position report to?
VP, Quality Improvement
What are the 3-4 non-negotiable requirements on this position?
Bachelor's degree in Business, Healthcare Administration OR related field. 3-4+ years of managed care operations experience with emphasis on Medicare. . 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. *Must have the Medicare Quality experience.
What are the nice-to-have skills?
Clinical experience STARS experience.
What is exciting about this opportunity? Please use this section to describe team and company culture.
To be part of one of the top rapidly growing managed care organizations! Tremendous growth opportunities available.
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