Business Consultant - Stars Outcomes (Hybrid)

Location: Greater Baltimore/Washington metropolitan area – hybrid model (part of the week remote, part on-site at a CareFirst location based on business needs).

About the role

The Business Consultant (Stars Outcomes) provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support Medicare Advantage Stars initiatives in the changing healthcare environment. The consultant owns an assigned set of 8–10 Star measures and drives enterprise performance to 4 Stars for each measure by collaborating with cross-functional accountable areas.

Responsibilities

• Lead governance and ownership for 8–10 assigned Star measures, managing 25–35 active interventions simultaneously.
• Develop and track detailed project plans, monitor progress, and proactively remove barriers.
• Create and maintain measure-level dashboards, identify trends and risks, and produce weekly executive-level scorecards.
• Support ongoing Stars strategy development and prepare presentations for committees, executive leadership, and stakeholders.
• Identify “data gaps in care” and partner with analytics teams to drive improvement in clinical measurement.
• Analyze member-outreach performance across internal, vendor, and provider channels; evaluate outreach effectiveness and recommend improvements.
• Coordinate outreach efforts to minimize duplication and maximize gap closure.
• Work with provider relations and value-based care teams to improve provider engagement in Stars work, including closing gaps in care, improving electronic clinical data submission, and driving achievement of provider quality incentives.
• Build trusted internal relationships to deepen subject-matter expertise, synchronize with core operations, and ensure close coordination with the central Stars team.

Requirements

• Bachelor’s degree OR, in lieu of a degree, an additional 4 years of relevant work experience beyond the required experience.
• 5 years of experience in business development, operational technology support, general business operations, and/or consulting.

Skills

• Expertise in Medicare Advantage Star Ratings and HEDIS.
• Strong understanding of healthcare operations, Medicare Advantage, and member experience.
• Ability to align work with business goals and priorities and follow evolving market, industry, and consumer trends.
• Effective communication of complex ideas both verbally and in writing.
• Exceptional project management, facilitation, and organizational skills.
• Excellent relationship management skills.
• Strategic thinker, problem solver, and collaborator who can drive engagement and discussions.
• Significant experience with MS Office (Excel, PowerPoint, Word).

Pay

Salary range: $88,848 – $176,462 (range considers scope, responsibilities, candidate experience, education/training, internal peer equity, and market factors; hiring is not typically at the top of the range).

Benefits

CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).