Consultant, Medicare Stars – Regulatory Performance Improvement

🔥 0 minutes ago

🏄 California, Illinois, +2 more states – Remote

🏄 California – Remote 🌽 Illinois – Remote 🗽 New York – Remote 🤠 Texas – Remote

💵 $90k - $125k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚔 Compliance

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Press Ganey

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1985

💼 Consulting

📦 Logistics

🏥 Healthcare

Consulting • Logistics • Healthcare

Press Ganey is a leading provider of patient experience measurement, performance analytics, and strategic advisory solutions for healthcare organizations. The company focuses on improving the overall healthcare experience through advanced analytics and human-centered insights, helping clients enhance patient and workforce safety, employee experience, and organizational growth. With a data-driven approach, they provide interactive dashboards, industry benchmarks, and actionable insights to drive measurable impact across the healthcare sector. Press Ganey collaborates with healthcare providers, health plans, and life sciences organizations to transform care delivery and improve human experiences in healthcare.

📋 Description

• Lead consulting engagements focused on Medicare Stars and regulatory performance improvement • Analyze and interpret data across HEDIS, CAHPS, HOS, Part D, operational measures, and Special Needs Plans (SNPs) • Conduct performance assessments, measure trending, gap analyses, cut-point modeling, and root cause analyses • Develop executive-level recommendations and actionable improvement strategies based on data insights • Partner with health plan and medical group stakeholders to identify quality, experience, and operational improvement opportunities • Design and facilitate workshops, training sessions, and process improvement initiatives • Manage project plans, timelines, deliverables, budgets, and engagement outcomes • Build client relationships and serve as a primary point of contact throughout engagements • Monitor CMS guidance, regulatory requirements, and technical specification updates and translate changes into client recommendations • Collaborate with cross-functional teams to integrate Stars consulting strategies with analytics, CAHPS, HOS, and member experience solutions • Provide consulting support across HEDIS, CAHPS, HOS, Part D, and SNPs • Guide clients through CMS and state requirements using readiness assessments, simulations, and strategic planning • Support M&A integrations, organizational restructuring, and SNP launches through governance design, stakeholder alignment, quality program optimization, and performance improvement strategies

🎯 Requirements

• 2+ years of experience in health plan quality, Medicare Stars, healthcare consulting, experience management, or performance improvement • Hands-on experience supporting Dual/SNP and MA Star Ratings performance • Knowledge of one or more quality domains, including HEDIS, CAHPS, HOS, Part D, medication adherence, or quality operations • Strong analytical and problem-solving skills with experience using Excel, Access, SQL, SAS, or similar tools • Demonstrated success driving measurable quality or performance improvement initiatives • Exceptional written, verbal, and presentation skills • Ability to influence stakeholders and communicate effectively with executive audiences • Advanced proficiency in Microsoft Office Suite, particularly Excel and PowerPoint • Strong project management and organizational skills • Bachelor's degree required • U.S.-based work location

🏖️ Benefits

• Competitive benefits package • Discretionary bonus or commission tied to achieved results • Remote work arrangement for U.S.-based employees • Reasonable accommodations for qualified individuals with disabilities or disabled veterans