Quality Stars Program Coordinator

About the role

The Quality Stars Program Coordinator will focus on clinical operations for Medicare Star initiatives and other quality improvement initiatives that interface with Clinical Services, Pharmacy, Quality Improvement and the Medical Economics Departments.

Responsibilities

• Works with VP, Quality Improvement and Clinical Quality Stars Program Manager to learn and apply the Medicare Part C&D Star Ratings Technical Notes.
• Communicates with the Medical Economics Department and the Clinical Quality Stars Program Manager to obtain ongoing HEDIS and Stars data collections to support SMART goals.
• Identifies opportunites for improvement, gap closure and facilitates the development of member and provider clinical data driven initiatives to promote optimal member outcomes and provider best practices.
• Assists with tracking systems for reporting KPIs for the evaluation of activities and the effectiveness related to program initiatives and other performance/quality improvement projects.
• Interfaces with the Provider Operations and Provider Experience teams for quality provider initiatives and provider education.
• Uses the PDSA cycle to identify barriers and opportunities for improvement related to Star ratings, NCQA, CAHPS and HOS surveys and other member experience or quality metrics.
• Aids in the development of training and educational material that directly impacts quality initiatives.
• Participates in quality improvement meetings and committees/subcommittees and focus groups.

Requirements

• Required Bachelor's degree or equivalent healthcare industry experience (five years).
• Minimum of two years of experience related to any of the following: Managed Care, Medicare Stars, HEDIS, CAHPS, HOS.
• Has the ability to prioritize and pivot to achieve goals with minimal supervision.
• Ability to build working relationships with internal staff and external stakeholders including community and vendor partners.
• Desired Medicare Star Ratings experience with the ability to analyze and interpret cut point predictions.

Qualifications

• Required Bachelor's degree or equivalent healthcare industry experience (five years).
• Minimum of two years of experience related to any of the following: Managed Care, Medicare Stars, HEDIS, CAHPS, HOS.
• Desired Medicare Star Ratings experience with the ability to analyze and interpret cut point predictions.

Skills

• Data analysis and reporting skills.
• Outreach and communication skills.
• Collaboration and relationship building skills.
• Quality improvement and project management skills.

Benefits

N/A

Pay

N/A

Schedule

8:00am - 5:00pm

40 hours per week