Manager, STARS Member Experience (52646)

About the role

This position provides guidance and training to the Quality department and organization-wide staff that impact member experience improvement initiatives. The role ensures the effective management of member experience survey ratings, including member and provider outreach.

Responsibilities

• Develops, plans, and implements initiatives and other quality member experience improvement strategies, making recommendations for change as needed.
• Directs the member experience processes to ensure the health plan is NCQA-accredited and is a 4+ STAR rating.
• Sets actionable and achievable goals for Quality Department implementation toward earning and maintaining a 4 STAR rating.
• Maintains an expert technical understanding of HEDIS, CAHPS, HOS, NCQA and Meaningful Use measures set by CMS performance standards.
• Manages and monitors performance for CAHPS/HOS survey vendor.
• Implements survey improvement initiatives including CAHPS committee meetings to ensure company-wide involvement to increase member survey scores.
• Creates wellness materials for marketing distribution to aid in member retention and health improvement efforts.
• Manages and monitors performance for CAHPS/HOS survey vendor.
• Develops and implements Medicare AWV/HRA program to increase provider and member participation.
• Creates training material on member experience surveys for organization-wide staff.

Requirements

Bachelor's degree or equivalent experience required. Five years of experience in a clinical or health insurance setting required. Five years of experience managing data to create reports required. Experience in medical quality, marketing, risk adjustment, coding, and/or wellness preferred. Requires a valid state drivers license. Knowledge of Microsoft applications (Word, Excel, Outlook) and basic electronic health record knowledge. Basic electronic health record knowledge and ability to quickly learn new software. Detailed knowledge of quality performance measures and clinical health care. Ability to communicate and manage complex working relationships. Strong organizational, verbal, written, time management, and telephone skills. Computer literate. Ability to collaborate across departments. May need to lift to 25 lbs. Supervisory responsibility includes serving as a coach and mentor for other positions in the organization that contribute to member experience ratings.

Qualifications

Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.

Skills and Abilities

• Communicates and manages complex working relationships.
• Trains internal and external parties.
• Organizes, writes, manages time, speaks on the phone, and uses computers.
• Understands quality performance measures and clinical health care.
• Collaborates across departments.

Benefits

N/A

Pay

N/A

Schedule

N/A