Senior Program Manager, Medicare Stars & Quality Improvement (Remote)

About the role

The organization operates within the healthcare industry, focusing on Medicare Stars quality improvement programs. It addresses challenges related to improving Medicare Star ratings by implementing quality improvement initiatives across enterprise and health plan teams.

The Senior Program Manager, Medicare Stars & Quality Improvement is responsible for leading and managing Medicare Stars programs and projects. This role drives quality improvement initiatives from design through completion, ensuring measurable outcomes that support improved Medicare Star ratings.

Responsibilities

• Collaborate with corporate and health plan teams to develop and implement Medicare Stars quality improvement programs.
• Manage, plan, and execute Medicare Star ratings programs, including oversight of associated staff.
• Support program execution and governance; communicate outcomes and develop improvement initiatives.
• Serve as Medicare Stars subject matter expert across functional areas.
• Translate needs and goals into functional requirements with measure owners.
• Lead leadership discussions providing recommendations and performance assessments.
• Advise operational leaders on process improvements and change management related to Medicare Stars.
• Facilitate process improvement, organizational change, and program management.
• Plan and direct program schedules and budgets.
• Develop and monitor program plans, schedules, deliverables, and outcomes.
• Track key performance indicators to measure program effectiveness.
• Create business documents including requirements, test plans, and training materials.
• Oversee projects from inception to delivery and outcomes measurement.
• Manage external vendor engagements as needed.
• Generate and distribute standard quality improvement and Medicare Stars reports.
• Provide training and expertise to Medicare Stars quality improvement team members.

Requirements

• Minimum 7 years of experience in Medicare Stars program and project management or equivalent.
• Strong knowledge of Medicare Star ratings and quality improvement programs.
• Advanced understanding of quality metrics and performance standards.
• Experience with government-sponsored programs such as Medicaid, Medicare, or Marketplace.
• Skilled in developing performance measures aligned with business objectives.
• Proficient in business writing.
• Strategic thinking and data analysis skills.
• Strong critical thinking, problem‑solving, and organizational skills.
• Experience implementing process improvements and managing change.
• Ability to work independently in a fast‑paced, deadline‑driven environment.
• Experience working in cross‑functional, highly matrixed organizations.
• Strong project management skills.
• Excellent verbal, written, and presentation communication abilities.
• Proficiency in Microsoft Office and ability to learn new software tools.

Pay

The pay range and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors.