Medicare Star Program Director — Hybrid, In-Office 3x/wk

The Elevance Health Companies, Inc.; Atlanta (GA); Hybrid; USD 180,000 - 240,000; Full time

Benefits offered by this job

Health insurance

401(k) + match

Stock purchase plan

Job summary

Elevance Health seeks a Director-equivalent leader to drive Medicare CMS Star program management, ensure quality and cost of care improvements, and oversee portfolio strategy across retail and medical benefits.

The role requires PharmD with 5+ years managed care experience, 3+ years in management, and an unrestricted RPh license. MBA and strong data analytics are highly valued in a hybrid in-office role.

Qualifications

• PharmD required with health plan/managed care experience preferred.
• Active RPh license in applicable state(s) required.
• MBA preferred or strong CMS Star knowledge is a plus.

Responsibilities

• Lead, develop, and implement CMS Star initiatives and programs to improve quality and cost of care.
• Serve as SME for CMS Star program implementations and performance monitoring.
• Ensure compliance and address quality of care issues across Star programs.
• Manage vendor relationships and contractual performance for program success.
• Collaborate with Quality, Pharmacy, Operations, Analytics, and Leadership teams.

Skills

CMS Star ratings

Program management

Vendor management

Data analysis

Stakeholder management

Cross-functional collaboration

Excel proficiency

Education

Doctor of Pharmacy (PharmD)

Active Pharmacist license (RPh)

Tools

Excel

Job description

Elevance Health seeks a Director-equivalent leader to drive Medicare CMS Star program management, ensure quality and cost of care improvements, and oversee portfolio strategy across retail and medical benefits.

The role requires PharmD with 5+ years managed care experience, 3+ years in management, and an unrestricted RPh license. MBA and strong data analytics are highly valued in a hybrid in-office role.