Medicare Stars Outcomes Consultant

CareFirst BlueCross BlueShield; Baltimore (MD); Hybrid; USD 89,000 - 176,000; Full time

Job summary

CareFirst BlueCross BlueShield in the Baltimore area is seeking a Business Consultant (Stars Outcomes) to drive Medicare Advantage Star initiatives. The role covers 8-10 star measures and requires leading cross-functional teams to achieve 4 Stars per measure, with a hybrid work model in the Greater Baltimore/Washington area.

The position focuses on governance, project planning, performance dashboards, and collaboration with analytics, provider relations, and care teams to close gaps in care and

Qualifications

• Bachelor's Degree required or, in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required.
• 5 years experience in business development, operational technology support, general business operations and/or consulting experience.
• Strong MS Office skills (Excel, PowerPoint, Word).

Responsibilities

• Provide subject matter expertise in Medicare Advantage Star Ratings and contribute to initiatives and goals.
• Lead governance and ownership for 8-10 Star measures, managing 25-35 active interventions.
• Develop and track detailed project plans, monitor progress, and remove barriers.
• Produce executive level scorecards and dashboards; support Stars strategy development.
• Collaborate with analytics, provider relations and care teams to close gaps in care and drive provider quality incentives.

Skills

Medicare Advantage Star Ratings

HEDIS

Healthcare operations

Communication skills

Project management

Relationship management

MS Office

Education

Bachelor's degree

Tools

MS Office

Job description

CareFirst BlueCross BlueShield in the Baltimore area is seeking a Business Consultant (Stars Outcomes) to drive Medicare Advantage Star initiatives. The role covers 8-10 star measures and requires leading cross-functional teams to achieve 4 Stars per measure, with a hybrid work model in the Greater Baltimore/Washington area.

The position focuses on governance, project planning, performance dashboards, and collaboration with analytics, provider relations, and care teams to close gaps in care and