Stars Manager - Member Experience (Hybrid)

About the Role

The Manager, Stars (Member Experience) leads a team and is responsible for the design, launch, and execution of cross-functional programs that support member experience and retention initiatives to improve the quality of care and member experience, resulting in 4 Star Ratings for Medicare Advantage plans.

Responsibilities

• Manages, develops, and leads a team responsible for driving member experience improvement in a matrixed organization environment.
• Develops and oversees strategy and execution of enterprise CAHPS strategy and initiatives.
• Analyzes key data points (such as CAHPS survey results, Pulse survey results, complaints, grievances, call center data) to develop strategy.
• Owns cross-functional relationships and works with key partners to drive member experience improvement that crosses multiple functional areas.
• Develop provider engagement strategy for CAHPS improvement.
• Oversee member experience surveys for all LOBs, including regulatory and non-regulatory surveys.
• Conduct impact analysis and formulate actions related to regulatory changes and implement appropriate changes and process improvements to drive CareFirst plans towards 4 Star outcomes.
• Collaborate across the ecosystem such as CMS, BCBSA, etc. to support necessary regulatory improvements to enable optimal Star ratings.
• Serve as a Member Experience/CAHPS/Stars SME to guide key stakeholders in bid filings and plan performance strategies and actions.
• Manage direct reports and vendors to execute goals related to STARS performance.
• Coach and guide associates to achieve departmental goals.
• Recruit, retain, and develop a high-performing team.
• Evaluate the performance of each team member, generate development plans, and set goals within the context of corporate policies and procedures.
• Develop annual goals and assist with departmental budget to control and appropriately allocate resources.
• Scale Medicare Advantage solutions for member experience across all lines of business.

Requirements

• Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
• 5 years of progressive responsibility in a healthcare payor environment.
• 1 year of supervisory or demonstrated progressive leadership experience within Government Programs.

Preferred Qualifications

• Master's in business administration, Master's in health administration, or Master's in public/population health.

Skills

• Expert knowledge of all regulatory guidelines on CMS Star Rating methodologies.
• Experience in member experience, healthcare operations, Medicare Advantage.
• Experience driving a Medicare Advantage plan to 4 Stars.
• Skilled in successfully planning and leading presentations to internal and external stakeholders, and C-suite with a focus on CMS Stars.
• Ability to work in a fast-paced environment and drive consistent actions across a matrixed environment.

Supervisory Responsibility

This position manages people.

Pay

The salary range for this position is $108,000 - $200,475. This range considers factors such as scope and responsibilities of the position, candidate's work experience, education/training, internal peer equity, and market and business considerations. It is not typical for an individual to be hired at the top of the range.

Benefits

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