CMS Stars Quality Improvement Lead

CommunityCare HMO Inc.; Tulsa (OK); On-site; USD 90,000 - 140,000; Full time

Job summary

CommunityCare HMO Inc. is seeking a Stars Manager to lead the design, implementation, and continuous improvement of CMS Star Ratings strategies.

You will guide cross-functional initiatives, leverage data analytics and regulatory expertise, and align efforts with corporate objectives to improve quality and member outcomes. You will develop strategy within a matrixed organization, ensuring timely updates to CMS requirements and collaboration with internal and external stakeholders.

Qualifications

• Excellent written, verbal, and presentation skills.
• Excellent analytical skills.
• Interpersonal skills to build relationships and advance STARS objectives.
• Proficiency with Microsoft Office applications.

Responsibilities

• Serve as SME on CMS Star Ratings; educate teams and ensure regulatory compliance.
• Monitor, evaluate, and report on Stars initiatives; identify improvements.
• Develop innovative approaches with stakeholders to improve engagement and Star Ratings outcomes.
• Analyze data from multiple sources to identify trends, solve problems, and plan improvements.
• Lead strategy to improve member experience and provider HEDIS engagement, targeting 4+ Star performance.
• Collaborate with data analysts to create tracking systems and KPIs for Star Ratings.

Skills

Communication skills

Analytical skills

Interpersonal skills

MS Office proficiency

Education

Background check for Health Care Sanctions

Tools

Microsoft Office

Job description

CommunityCare HMO Inc. is seeking a Stars Manager to lead the design, implementation, and continuous improvement of CMS Star Ratings strategies.

You will guide cross-functional initiatives, leverage data analytics and regulatory expertise, and align efforts with corporate objectives to improve quality and member outcomes. You will develop strategy within a matrixed organization, ensuring timely updates to CMS requirements and collaboration with internal and external stakeholders.