Medicare Stars Quality Improvement Lead

Inland Empire Health Plans; Rancho Cucamonga (CA); On-site; USD 95,000 - 130,000; Full time

Benefits offered by this job

Competitive salary

On-site fitness center

Medical, dental, vision insurance

Life, disability coverage

Career development opportunities

Wellness programs

Retirement plans (CalPERS)

457(b) with match

Pet care insurance

Job summary

Inland Empire Health Plans (IEHP) seeks a Quality Improvement (QI) Facilitator III – Medicare Stars to serve as an SME for Medicare Stars regulations and program requirements. You will lead cross-functional projects, translate CMS expectations into actionable workflows, and drive Stars performance excellence.

Reporting to the Director, Medicare Stars, you will manage resource prioritization, deliverables, and continuous improvement initiatives across clinical, operational, and provider-facing

Qualifications

• Master’s degree in public health or related field is required.
• PMI/CPHQ or equivalent quality cert required or to be completed within 1 year of hire.
• Advanced knowledge of CMS/NCQA/HEDIS and quality measurement is expected.
• Strong analytical skills and proficiency in MS Office, especially Excel, PowerPoint, Visio.

Responsibilities

• Lead complex Medicare Stars quality initiatives across cross-functional teams.
• Translate CMS expectations into actionable workflows and ensure alignment with CMS Star Ratings program requirements.
• Oversee quality improvement projects, prioritize resources, and manage deliverables to improve organizational performance.

Education

Master’s degree in public health, health administration, public administration, or related field

Project Management Professional (PMP) Certificate or Certified Professional of Healthcare Quality (CPHQ) or similar

Advanced knowledge of healthcare quality performance and measurement sets (CMS, NCQA, HEDIS)

Strong analytical and Excel proficiency

Tools

MS Office (Excel, PowerPoint, Visio)

Job description

Inland Empire Health Plans (IEHP) seeks a Quality Improvement (QI) Facilitator III – Medicare Stars to serve as an SME for Medicare Stars regulations and program requirements. You will lead cross-functional projects, translate CMS expectations into actionable workflows, and drive Stars performance excellence.

Reporting to the Director, Medicare Stars, you will manage resource prioritization, deliverables, and continuous improvement initiatives across clinical, operational, and provider-facing