Senior STARS Consultant - Remote

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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

This is a remote role

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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 .

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.

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

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.

Originally posted on Himalayas