Medicare Advantage Stars Quality & Risk Lead

Southcarolinablues; Columbia (SC); Hybride; USD 140 000 - 180 000; Plein temps

Avantages offerts par ce poste

Health plans

401k with company match

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Résumé du poste

BlueCross BlueShield of South Carolina is seeking an AVP of Quality and Risk Performance to lead Stars rating improvement, risk adjustment, and value-based programs for Medicare Advantage. Based onsite in Columbia, SC, you will diagnose performance gaps, craft strategic plans, and translate data insights into actionable initiatives.

Strong leadership and CMS regulatory knowledge are required. You will oversee risk adjustment initiatives, RADV readiness, and coding capture optimization while

Qualifications

• Bachelor's degree required.
• 10+ years in insurance/healthcare or similar.
• 3 years Medicare Advantage Stars rating experience.

Responsabilités

• Develop and implement strategies to improve Medicare Stars ratings.
• Lead cross-functional teams to drive Stars initiatives.
• Communicate progress and actions to senior leadership.
• Manage vendor relationships and ensure performance.

Connaissances

Leadership

Team leadership

Communication

Interpersonal skills

Relationship building

Strategic thinking

Formation

Bachelor's degree

Outils

Microsoft Office

PowerPoint

Excel

Description du poste

BlueCross BlueShield of South Carolina is seeking an AVP of Quality and Risk Performance to lead Stars rating improvement, risk adjustment, and value-based programs for Medicare Advantage. Based onsite in Columbia, SC, you will diagnose performance gaps, craft strategic plans, and translate data insights into actionable initiatives.

Strong leadership and CMS regulatory knowledge are required. You will oversee risk adjustment initiatives, RADV readiness, and coding capture optimization while