Quality Program Manager Health Plan Medicare Advantage Stars *Remote*

Job description

**Description**



**Quality Program Manager - Health Plan Medicare Advantage Stars** **_Remote_**



**The Quality Program Manager – Health Plan Medicare Advantage Stars is tasked with serving as a health plan Star Ratings Subject Matter Expert (SME) who is experienced at using Stars data, CMS Star Rating Technical Notes and HPMS memos to develop and implement best-practice interventions that result in improved Star ratings.**



**The Health Plan Medicare Advantage Stars Quality Program Manager will:**



+ Develop and implement best-practice interventions to improve Medicare Advantage Star Ratings, driving clinical quality indicators (HEDIS Star metrics), CAHPS, and HOS efforts.

+ Utilize reports and dashboards to identify and socialize Star rating trends, gaps, and areas for improvement and use the data to develop action and monitoring plans.

+ Collaborate with various health plan departments (care management, customer service, outreach, product, sales, marketing, etc.) to develop and implement best-practice Stars initiatives that result in improved ratings.

+ Ensure compliance with CMS Stars deliverables (e.g.: plan previews, final HEDIS, CAHPS, HOS results) and keep abreast of changes affecting Star Ratings (e.g.: measure changes, weights, cut points).

+ Monitor and report on Stars program performance, delivering insights, interventions, impact to workgroups, committees, executives.

+ Develop and manage relationships with external partners, stakeholders, vendors involved in Stars initiatives.

+ Demonstrate strong project management skills, capable of organizing, facilitating, and managing multiple projects and programs simultaneously.

+ Fully understand health plan operations and levers that result in Medicare Advantage Stars improvement.

Health plan Medicare Stars experience, and understanding is critical in this role.



**Providence welcomes virtual work for applicants who reside in one of the following States:**



+ Washington

+ Oregon



**Required Qualifications:**



+ Bachelor's Degree **-OR-**

+ Master's Degree in Public Health, Business Administration, Health Science, Health Services Administration, or other healthcare or business-related field **-OR-** a combination of equivalent education and work experience

+ 3 or more years of related experience working in, or with a managed care organization or clinical setting in a managed care environment

+ 3 or more years of experience in project management or program management

+ Demonstrated experience in program planning, development, and evaluation



**Preferred Qualifications:**



+ Experience in quality management principles, tools, and techniques

+ 5 or more years of experience in project management or program management

+ Experience with Stars program oversight, including intervention development and implementation for clinical quality (Stars HEDIS) measures, CAHPS, HOS

+ Deep understanding of the Medicare Advantage Stars program, CMS Star Rating Technical Notes, HPMS memos, and ability to interpret, communicate, and action CMS guidance specific to the Stars program



**Salary Range by Location:**



+ Oregon: Non-Portland Service Area: Min: $42.08, Max: $65.32

+ Oregon: Portland Service Area: Min: $45.14, Max: $70.07

+ Washington: Western - Except Tukwila: Min: $47.05, Max: $73.04

+ Washington: Southwest - Olympia, Centralia: Min: $45.14, Max: $70.07

+ Washington: Clark County: Min: $45.14, Max: $70.07

+ Washington: Eastern: Min: $40.16, Max: $62.35

+ Washington: Southeastern: Min: $42.08, Max: $65.32



**Why Join Providence?**



Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.

We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.



**About Providence**

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others.

We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected.

Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.

As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.



The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.



Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more.

Learn more at providence.jobs/benefits.



Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.



**About the Team**

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.

We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.



Providence is proud to be an Equal Opportunity Employer.

We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
**Requsition ID:** 389052
**Company:** Providence Jobs
**Job Category:** Clinical Quality
**Job Function:** Quality/Process Improvements
**Job Schedule:** Full time
**Job Shift:** Day
**Career Track:** Business Professional
**Department:** 5018 HCS QUALITY MANAGEMENT OR REGION
**Address:** OR Beaverton 3601 SW Murray Blvd
**Work Location:** Murray Business Ctr Beaverton-Beaverton
**Workplace Type:** Remote
**Pay Range:** $see posting - $see posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Required Skill Profession

Other General