Consultant, Stars Consulting Center of Excellence
$90,000–$125,000 year
RemoteTennessee, United States
Job Summary
Utilize Press Ganey and client data assets to consult stakeholders on industry changes and improvement opportunities, adapting to evolving requirements. Partner with health plans to complete data analysis, interpretation, and process design that identifies and solves business problems. Construct and lead data analysis across Stars measure domains including CAHPS, HEDIS, HOS, medication adherence, and operational measures, summarizing conclusions and recommendations. Serve as the direct point of contact with clients, building strategic relationships and influencing various audiences to communicate risks and recommendations. Coordinate engagement plans, manage deliverables including quality reviews and presentations, and integrate Stars consulting outputs with Hyperlift analytics. Monitor CMS guidance and technical specification updates to summarize implications for clients and the team.
Required Qualifications
- 2+ years of previous work experience in health plan quality, Star Ratings, and/or experience management, with hands-on exposure to Medicare Advantage
- Quality experience Specific experience/background in one or more of the following: HEDIS operations and rate improvement, including measure specifications, supplemental data, and medical record review
- Quality experience Specific experience/background in one or more of the following: CAHPS and member experience improvement across lines of business
- Quality experience Specific experience/background in one or more of the following: medication adherence and Part D measures
- Quality experience Specific experience/background in one or more of the following: HOS and health outcomes measurement
- knowledge and understanding of government programs driven by Medicare Stars and NCQA
- proven track record of quality or experience improvement with health plan stakeholders
- Exposure to Special Needs Plans (D-SNP, C-SNP, or I-SNP), including SNP-specific quality, compliance, and member experience considerations
- Demonstrated experience in driving performance improvement initiatives
- Requires strong data analytic skills (Excel, Access, SQL, SAS, etc.)
- Advanced skills in MS Office Products (Word, PPT, Excel) to support document preparation
- Ability to work under pressure to meet deadlines and to quickly adapt to multiple priorities
- Bachelor's degree
- Remote US Based
- Up to 50% Travel
Desired Qualifications
- Exposure to Special Needs Plans (D-SNP, C-SNP, or I-SNP), including SNP-specific quality, compliance, and member experience considerations, strongly preferred
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