CMS Stars Quality Improvement Leader

CommunityCare HMO Inc.; Tulsa (OK); On-site; USD 95,000 - 145,000; Full time

Job summary

CommunityCare HMO Inc. in Tulsa, OK is seeking a Stars Manager to lead design, implementation, and continuous improvement of CMS Star Rating initiatives.

You will drive cross-functional collaboration, leverage data analytics and regulatory insight to optimize member outcomes and quality performance. Responsibilities include developing strategy, communicating goals within a matrixed organization, and guiding programs to achieve 4+ star performance in CMS ratings while aligning with corporate

Qualifications

• Excellent written, verbal, and presentation skills.
• Excellent analytical skills.
• Interpersonal skills to create relationships and advance STARS objectives.
• Proficient in Microsoft Office applications.
• Successful completion of Health Care Sanctions background check.

Responsibilities

• Serve as a subject matter expert on CMS Star Ratings and educate teams across the organization.
• Continuously monitor, evaluate, and report on Stars initiatives and identify improvement opportunities.
• Ensure best practices and develop innovative approaches with stakeholders to improve engagement and Star Ratings outcomes.
• Analyze data from multiple sources to identify trends and drive continuous improvement across Stars measures.
• Lead strategy to improve member experience and provider HEDIS engagement and support 4+ Star performance.
• Collaborate with data analysts to develop targeting and monitoring capabilities and KPIs.
• Prepare leadership decks, anticipate issues, and provide strategic recommendations for Star Ratings advancement.
• Stay informed of CMS changes and industry best practices and update programs accordingly.
• Engage external vendors as needed to deliver high-quality results for Star Ratings objectives.
• Manage workload to meet deadlines with clear communication.

Skills

Written communication

Analytical skills

Interpersonal skills

Microsoft Office proficiency

Healthcare sanctions background check

Education

Bachelor’s degree in Nursing, Business, Finance, healthcare or related field

Master’s degree preferred in healthcare (MPH/MSN/MHA)

Tools

Microsoft Office

Job description

CommunityCare HMO Inc. in Tulsa, OK is seeking a Stars Manager to lead design, implementation, and continuous improvement of CMS Star Rating initiatives.

You will drive cross-functional collaboration, leverage data analytics and regulatory insight to optimize member outcomes and quality performance. Responsibilities include developing strategy, communicating goals within a matrixed organization, and guiding programs to achieve 4+ star performance in CMS ratings while aligning with corporate