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Medicare Stars Analyst

Job Posting
Medicare Stars Analyst
Greensboro, NC • Medicare STARS
Description

Job Summary

Reporting to the Manager Medicare Stars, this individual will play a critical role in executing HealthTeam Advantages’ Quality and STARs programs with the implementation of the NCQA and CMS compliant STARs functions, projects, roadmap development, reporting, audit, and submissions. This position will provide oversite, direction, and assistance to the delegated partner responsible for provider communications, quality programming, abstracting data, formatting data, and submitting data to ensure that data submitted is accurate and meets all CMS deadlines. The Medicare STARs Analyst will lead implementation strategies to achieve desired quality outcomes and STAR measures.

Major Work Activities

Responsible for the annual development and implementation of the Plan’s Star Quality Plan to include coordination/tracking of each Star requirement per CMS’s technical specifications across multiple contracts
Manage and work with Stars program management team, health plan, and provider leadership to develop and execute Stars strategy; think strategically and translate business strategy into initiatives.
Responsible for analyzing, compiling, and validating Stars-related data.
Responsible for the tracking of STAR measures through HEDIS software, HPMS, and other reporting platforms, including identifying/resolving issues related to processing, data, and/or STARs program.
Ensures effectiveness of Stars programs by working across the organization and its providers, leading work plan meetings, and conducting regular deep dives with functional teams to ensure initiatives are directly aligned with Star measure improvement
Independently, or in teams, apply analytics programs/tools to develop and execute complex, ad-hoc analysis of clinical, claims, and other data to surface insights regarding plans multiple contracts performance.
Project manage the collaboration with operations, delegated partners, and external vendors for the development and implementation of STAR-related activities.
Plan lead for Star-related initiatives including Health Fair management, member identification, implementation, and execution.
Collaborates across the Plan and with vendors to identify areas of educational need.
Independently, or in teams, produce, interpret and explain reports monthly and as needed to support generating actionable outcomes for Plan quality initiatives.
Support and participate in improving STAR measures identified by Quality.
Responsible for identifying trends or areas of concern of STARs data supplied by HTA’s delegated partners, including the accuracy and validity of source data and results. Demonstrating an advanced level of attention to detail and initiative in discovering errors in data or analysis, or determining the need for additional, follow-up analysis arising from the original data.
Responsible for analyzing and making recommendations to improving STAR measures in conjunction with HTA’s delegated partners.
Including management of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) vendor, HOS vendor processing, and results


Requirements

Minimum Qualifications

Required Education

Bachelor’s Degree or four (4) or more years equivalent work experience

Required Experience

Four (4) or more years experience in health insurance, Medicare Advantage, Accountable Care Organization, or other similar healthcare setting
Experience in managerial or program development positions in healthcare settings
Proficient in Word, Excel, and PowerPoint
Demonstrated organization and facilitation, communication, and presentation skills.
Experience coordinating/project managing multiple initiatives simultaneously
Experience interacting with healthcare professionals, auditors, external vendors, and CMS.
Knowledge, Skills, and Abilities
Experience working with regulatory agencies and compliance environment with practical knowledge of Medicare Regulations
Knowledge, Skills, and Abilities

Knowledge of applicable STAR/NCQA/CMS requirements

Strong in the following competencies:

Decision making/Judgment
Problem solving/Analysis
Communication
Creativity/Innovation
Ability to work independently

Preferred Qualifications

Preferred Education

Bachelor’s Degree in business or health-related field

Preferred Experience

Two (2) or more years demonstrated experience with Medicare Advantage STARs program experience
Preferred Knowledge, Skills, and Abilities

Strong project management skills

Time:  Full time
Salary:  Salary
Category:  Administration

Updated: 5/18/2021 10:09:23 AM

Job Contact:
Michael Abner
3364483122

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7800 McCloud Road
Greensboro, NC 27409

3364483122