Medicare CAHPS & STAR Quality Program Lead

Elevance Health; Durham (NC); Hybrid; USD 90,000 - 140,000; Full time

Job summary

Elevance Health is seeking a Medicare CAHPS & STAR Quality Clinical Program Manager to lead population-based clinical quality measures across lines of business. The role emphasizes strategic program design, vendor management, ROI analysis, and regulatory compliance within a hybrid work setting.

You will develop and implement annual plans, oversee vendor relationships, and drive improvement in member experience while ensuring alignment with CMS guidelines and Star/CAHPS objectives.

Qualifications

• BA/BS in business, public health, nursing, epidemiology/biostatistics or related field.
• Minimum 5 years of health care data analysis and clinical program development experience.

Responsibilities

• Provides strategic leadership for Medicare clinical and quality programs (Stars and CAHPS).
• Oversees ideation through implementation of Medicare quality and patient experience programs.
• Manages vendor contracts, SLAs, and monitors vendor performance.
• Creates workflows, prioritizes work, and manages multiple projects to meet deadlines.
• Develops clinical programs/tools with reference to CMS regulations and best practices.
• Develops annual plans detailing strategies, programs, and tools to implement.
• Leads program development activities and coordinates presentations and communications across all phases.

Skills

AI prompts

Member experience

Quality Medicare Star

CAHPS programs

Vendor management

Medicare Part D

CMS regulations

Analytical skills

Education

BA/BS in business/public health/nursing/epidemiology/biostatistics

Job description

Elevance Health is seeking a Medicare CAHPS & STAR Quality Clinical Program Manager to lead population-based clinical quality measures across lines of business. The role emphasizes strategic program design, vendor management, ROI analysis, and regulatory compliance within a hybrid work setting.

You will develop and implement annual plans, oversee vendor relationships, and drive improvement in member experience while ensuring alignment with CMS guidelines and Star/CAHPS objectives.