Senior Director Star Ratings & Quality Center of Excellence - Remote
$143,000–$243,000 year
On-siteHome, Washington, United States
Job Summary
Formulate strategic and tactical plans, processes, and tools to establish quality procedures that drive Medicare Star Ratings and measurable results. Develop a comprehensive Medicare Star Ratings and CAHPS strategy to attract members, achieve quality bonus payments, and reduce total cost of care. Lead a cross-functional Center of Excellence workgroup with clinical, member experience, and data partners to drive synergies for new product development. Provide strategic consultation to clients and manage a team of quality managers and data analysts, including budget, performance, and resource planning. Ensure proactive monitoring of regulatory policy changes and represent Prime in RFP responses, industry conferences, and client meetings.
Required Qualifications
- Bachelor's degree in business, health services or related area of study, or equivalent combination of education and/or relevant work experience
- HS diploma or GED
- 10 years of work experience in Medicare Star Rating quality programs, analytics, audit, compliance, operational compliance, or related field
- 7 years of leadership/people management experience
- Must be eligible to work in the United States without need for work visa or residency sponsorship
- Strategic planning and execution
- Excellent written and verbal communication skills with the demonstrated ability of presenting program and project updates to senior executives
- Strong organizational, analytical, interpretative, and time management skills
- Strong interpersonal skills including team leadership and collaboration
- Understanding of CMS Star Rating regulatory requirements / technical specifications
- Strong commitment and proven track record of continuous quality improvement
- Demonstrated ability to identify and develop quality programs and process improvements
Desired Qualifications
- Experience working with cross-functional partners both internally and externally
- Experience with analytical tools such as Excel, Access data bases, SaaS
- Strong client consulting presence: ability to distill complex material into easy to understand presentations, effectively respond to questions and engage a variety of audiences
- Ability to communicate effectively with senior leaders across the organization
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