Medicare Quality Administrator - Michigan Residency Required jobs in United States
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McLaren Health Care · 4 days ago

Medicare Quality Administrator - Michigan Residency Required

positionFlint, MI
timeFull-time
remoteHybrid
seniorityEntry, Mid Level
date2+ years exp

McLaren Health Care is a leading organization in the healthcare sector, looking for a Quality Administrator Medicare to enhance their quality performance. The role involves strategizing and improving Medicare Star ratings while collaborating with various teams to implement quality-related projects and ensure compliance with regulatory standards.

Health CareHospitalMedicalOncologyRehabilitation
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H1B Sponsor Likelynote

Responsibilities

Responsible for delivering, strategizing, and improving quality performance with a focus on Medicare Star ratings
This position supports the design, development, implementation, and evaluation of quality programs focused on improving the plan’s Medicare Star ratings
This individual will collaborate with leadership and cross-functional teams to support the design and execution of quality-related projects and programs to advance organizational priorities related to quality performance
Responsible for proposing targeted actions, aiding in the development of the interventions and coordinating the implementation of all quality operations
Coordinates specific regulatory and contractual responsibilities including, but not limited to, HEDIS, CAHPS, HOS, and NCQA Standard compliance, performance projects, site audits, and any other regulatory requirements

Qualification

Quality managementMedicare managed careHEDISNCQA complianceClaims administrationICD-10Leadership collaborationProject management

Required

Bachelor's degree in health care, business or a related field, or Associate's degree and two (2) years' related experience
Two (2) years' experience performing quality management activities in a Medicare managed care organization, including HEDIS, HOS, and CAHPS

Preferred

Master's degree in health care related field
Four (4) years' experience with a government regulated health organization or a managed care setting with at least three (3) years' experience performing complex quality management activities including HEDIS, NCQA etc
In-depth understanding of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc
Experience and knowledge of ICD-10, CPT I, CPT II, LOINC, SNOMED, HCPCS diagnosis

Company

McLaren Health Care

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McLaren Health Care is a fully integrated health network committed to quality evidence-based patient care and cost efficiency.
dateFounded in 1914
location
Grand Blanc, Michigan, USA
people-size10001+ employees
web-link
http://www.mclaren.org

H1B Sponsorship

McLaren Health Care has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2024 (3)
2023 (1)
2022 (1)
2021 (4)

Funding

Current Stage
Late Stage
Total Funding
unknown
2021-01-01Acquired

Leadership Team

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Chris Candela
President and Chief Executive Officer McLaren Flint
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Chad Grant
Executive Vice President & Chief Operating Officer
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