Senior STARS Consultant

Job not on LinkedIn

🔥 6 minutes ago

🇺🇸 United States – Remote

💵 $69.8k - $125.9k / year

⏰ Full Time

🟠 Senior

💼 Consultant

🦅 H1B Visa Sponsor

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Serve as the functional liaison between the Intake team and operations teams • Support Medicare and Star Ratings-related business initiatives • Review project scope • Support business needs throughout the delivery cycle • Manage production and/or system change requests to deliver enterprise initiatives • Research and analyze business impacts against project scope • Support effective project delivery for medium-complexity initiatives spanning multiple business functions • Facilitate communication of changes, enhancements, and operational updates to impacted business units • Support successful implementation and business outcomes

🎯 Requirements

• 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 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 • Sponsorship is not available • Preferred: Demonstrated experience supporting or leading Medicare Advantage Star Ratings initiatives with measurable quality improvement outcomes • Preferred: Deep understanding of HEDIS measures, quality reporting methodologies, and strategies used to improve Star Ratings performance • Preferred: In-depth knowledge of Medicare Advantage products, CMS regulations, and the Medicare regulatory environment • Preferred: Experience using dashboards, scorecards, and performance reporting tools to identify trends, gaps, and intervention opportunities • Preferred: Experience with Inovalon, Cotiviti, or other quality measurement and HEDIS platforms • Preferred: MBA, MPH, MHA, or related master's degree with demonstrated analytical, strategic, and problem-solving capabilities • Preferred: Experience supporting healthcare quality, operational, and performance improvement initiatives • Preferred: Working knowledge of SQL and healthcare data analysis methodologies • Preferred: Vendor oversight and management experience

🏖️ Benefits

• Curated development plans supporting professional development and career growth • 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 • Annual incentive bonus plan subject to plan terms and conditions • Other incentives