Senior Healthcare Quality Consultant – Medicare

Job not on LinkedIn

🔥 1 minute ago

☕ Washington – Remote

☕ Washington – Remote

💵 $147.4k - $279.7k / year

⏰ Full Time

🟠 Senior

💼 Consultant

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Milliman

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1947

🏥 Healthcare

🛡️ Insurance

💼 Consulting

Healthcare • Insurance • Consulting

Milliman is an independent global actuarial and consulting firm founded in 1947 that provides expertise in insurance, healthcare, retirement and employee benefits, risk management, and related financial services. The firm combines actuarial rigor, data science, and technology to deliver consulting, modeling, software, and advisory solutions to public- and private-sector clients addressing challenges such as healthcare costs, market volatility, climate risk, and program design. Milliman operates worldwide with multidisciplinary teams including actuaries, data scientists, clinicians, and software engineers.

📋 Description

• Advise Medicare Advantage organizations on Star Ratings strategy, quality improvement, and operational performance • Lead consulting engagements focused on CAHPS, HOS, and member experience • Assess performance drivers and develop and implement targeted improvement strategies and interventions • Translate measure performance and regulatory changes into operational priorities and actionable improvement plans • Collaborate across quality, member experience, clinical operations, provider engagement, pharmacy, customer service, analytics, and executive leadership functions • Develop governance structures, workplans, performance monitoring approaches, and accountability processes • Combine quantitative analysis with operational knowledge to identify practical improvement opportunities • Contribute subject matter expertise to Milliman research, analytics, and thought leadership • Help expand Milliman’s Medicare quality and Star Ratings consulting capabilities, service offerings, and client solutions • Mentor consultants through informal guidance and knowledge-sharing • Participate in business development, identify opportunities, and contribute to client proposals

🎯 Requirements

• Bachelor’s degree required • 7+ years of healthcare quality, Medicare Advantage, health plan operations, or related experience • Substantial experience focused on Medicare Advantage Star Ratings • Experience developing and implementing quality improvement strategies and interventions • Significant experience with HEDIS, CAHPS, and HOS performance improvement • Understanding of operational drivers of quality results and approaches to improving performance • Strong analytical background and ability to translate data into actionable recommendations • Self-directed and comfortable operating independently as a senior, client-facing advisor • Willingness to mentor junior staff and share expertise informally • Interest in growing a practice through new and expanded client relationships • Ability to communicate complex quality and regulatory issues clearly and practically • Legally authorized to work in the United States without immigration support or sponsorship • Preferred: experience representing an organization at industry conferences and professional events • Preferred: advanced degree in healthcare administration, public health, business administration, health policy, nursing, or related field • Preferred: experience developing new consulting offerings or building a Medicare quality or Star Ratings practice • Preferred: experience in both a Medicare Advantage health plan and healthcare consulting/advisory environment • Preferred: experience contributing to healthcare quality research and industry publications

🏖️ Benefits

• Medical, Dental and Vision coverage for employees, dependents, and domestic partners • Employee Assistance Program (EAP) • 401(k) plan with company matching and profit-sharing • Discretionary Bonus Program • Flexible Spending Accounts (FSA) • Paid Time Off (PTO) • Minimum of 10 paid holidays per year • Family Building Benefits, including adoption and fertility benefits • Up to 11 weeks of paid parental leave for eligible employees • Life Insurance and AD&D with 100% of premiums covered • Fully paid short-term and long-term disability • Skills training and career development • Learning and mentoring opportunities • Employee Resource Groups (ERGs)