Program Manager, Medicare Stars & Quality Improvement

Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities.

Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare Star ratings.

Responsible for leading and managing Medicare Star projects and programs involving enterprise, department, cross-functional and health plan teams of subject matter experts, delivering impactful quality improvement initiatives through design process to completion and outcomes measurement.

• Collaborates with cross-functional corporate and health plan teams on the development and implementation of enterprise Medicare Stars quality improvement (QI) programs and initiatives across the enterprise.
• Manages, plans and executes Medicare Star ratings programs.
• Supports Stars program execution and governance needs; communicates, measures outcomes and develops initiatives to improve Star ratings.
• Serves as the Medicare Stars subject matter expert to corporate functional areas/health plans, and leads programs to meet critical needs.
• Communicates and collaborates with health plans and Stars measure owners to analyze and transform needs and goals into functional requirements to maximize improvement opportunities.
• Leads health plan leadership discussions to provide recommendations, performance results and opportunity assessments for Medicare Stars improvement.
• Collaborates with operational leaders within the business to provide recommendations on opportunities for process improvements, organizational change management, program management and other processes related to Medicare Star ratings.
• Facilitates process improvement, organizational change management, program management and other processes relative to the Medicare Stars Program.
• Plans and directs schedules for program initiatives, as well as program budgets.
• Develops, defines, and executes plans, schedules, and deliverables; monitors programs from initiation through delivery through outcomes measurement.
• Monitors and tracks key performance indicators (KPIs), programs and initiatives to reflect the value and effectiveness of Stars and QI programs.
• Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documents.