Senior STARS Consultant - Remote

HCSC Group; United States; Teletrabalho; USD 70 000 - 126 000; Tempo integral

Resumo da oferta

Health Care Service Corporation is seeking a role that serves as the functional liaison between the Intake team and operations, supporting Medicare and Star Ratings initiatives. You will review project scope, support delivery, and manage production/change requests to deliver enterprise initiatives.

The role also researches impacts and facilitates communication of changes to ensure successful outcomes. The candidate will work across departments, apply analytics to measure impact, and support

Qualificações

• Bachelor’s degree required.
• 5 years of healthcare industry or health insurance work experience.
• Previous Medicare experience preferred.
• Strong written and oral communication skills.
• Organizational skills with ability to prioritize tasks.
• Presentation skills and executive presence.
• Experience communicating with senior management across departments.
• Analytical thinking and problem solving abilities.
• Business acumen with project/program management skills.

Responsabilidades

• Serve as liaison between Intake and operations for Medicare/Star Ratings initiatives.
• Review project scope and support the delivery cycle.
• Manage production or system change requests to enable enterprise initiatives.
• Research business impacts and aid successful project delivery.
• Communicate changes and updates to impacted business units.
• Support teams across multiple departments to drive outcomes.

Conhecimentos

Communication skills

Organizational skills

Presentation skills

Executive presence

Analytical thinking

Problem solving

Business acumen

Project management

Senior management interaction

Medicare knowledge

Formação académica

Bachelor’s degree

MBA/MPH/MHA or related master’s degree

Ferramentas

SQL

Inovalon

Cotiviti

Descrição da oferta de emprego

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Job Summary

This position serves as the functional liaison between the Intake team and operations teams, supporting Medicare, and Star Ratings related business initiatives. Responsibilities include reviewing project scope, supporting business needs throughout the delivery cycle, and managing production and/or system change requests to deliver enterprise initiatives. The role researches and analyzes business impacts against project scope and supports effective project delivery for medium-complexity initiatives that may span multiple business functions. Additionally, the position facilitates communication of changes, enhancements, and operational updates to impacted business units to support successful implementation and business outcomes.

Required Job Qualifications

• Bachelor’s degree
• 5 years of healthcare industry or health insurance work experience
• Previous experience with Medicare
• Strong written and oral communication skills
• Organizational skills, including ability to prioritize tasks.
• Presentation skills and executive presence
• Experience with interacting successfully with senior management and staff of all levels across multiple departments
• Analytical thinking, and problem-solving skills
• Business acumen and project / program management skills

Preferred Job Qualifications

• Demonstrated experience supporting or leading Medicare Advantage Star Ratings initiatives with measurable quality improvement outcomes.
• Deep understanding of HEDIS measures, quality reporting methodologies, and strategies used to improve Star Ratings performance.
• In-depth knowledge of Medicare Advantage products, CMS regulations, and the Medicare regulatory environment.
• Experience utilizing dashboards, scorecards, and performance reporting tools to identify trends, gaps, and opportunities for intervention.
• Experience with Inovalon, Cotiviti, or other quality measurement and HEDIS platforms.
• MBA, MPH, MHA, or related master's degree with demonstrated analytical, strategic, and problem-solving capabilities.
• Experience supporting healthcare quality, operational, and performance improvement initiatives.
• Working knowledge of SQL and healthcare data analysis methodologies.
• Vendor oversight and management experience.

Sponsorship is not available

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

• From health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• plus other incentives

We offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Base Pay Range $69,800.00 - $125,900.00 Exact compensation may vary based on skills, experience, and location.

This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

This is a remote role #LI-KW1 #LI-remote #INAK

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.