HealthPartners · 1 day ago
Medicare Star Ratings Consultant
Bloomington, MN
Full-time
Onsite
Mid, Senior Level
4+ years expHealthPartners is a nonprofit, integrated health care organization that is currently hiring for a Medicare Star Ratings Consultant. The consultant will lead the design and execution of Medicare Stars strategies to improve the health plan product’s CMS Star Ratings, focusing on member experience and collaboration across teams.
MedicalPharmaceutical
Responsibilities
(50%) Monitor member experience indicators and identify opportunities for improvement
Serves as the stars subject matter expert on Medicare CAHPS performance indicators and trends
Leads the development of data collection and reporting methods to monitor member experience and Medicare CAHPS performance
Monitors and analyzes member experience indicators and Medicare CAHPS outcomes to ensure goals, objectives, outcomes are met
Monitors for adverse trends, performs root cause analysis, recommends process improvement modifications and corrective actions
Works within plan, care group, providers, and vendors to review best practices, programs, and processes for improvement opportunities. Responsible for bringing forward recommendations to the Stars leadership team
(50%) Acts as the lead of Medicare member experience initiatives. Collaborate with cross-departmental business leaders, external partners, and vendors to achieve common goals
Provides Medicare CAHPS education and to the whole organization and external partners
Provides Medicare CAHPS performance reporting to all levels of staff including executive leadership
Leads and/or participate in internal and external activities, workgroups, meetings, etc. that support Medicare CAHPS performance
Develop strong business partnerships with key areas throughout the organization and external partners to continually improve Medicare CAHPS performance
Perform other duties assigned to ensure business needs are met
Job description rankings/percentages are intended to reflect normal averages over an extended period of time and are subject to daily variances. Quality and efficiency standards should at no time be compromised to meet the average
Qualification
Required
Bachelor's degree in business, health care administration, health policy or other relevant discipline or equivalent years of related work experience
Four (4) years of professional experience in a health plan or managed care setting, with relevant work in Medicare Advantage or other Medicare products
Two (2) years of experience with Medicare Star ratings or other similar quality improvement framework
Proven history of building and sustaining collaborative relationships across all levels of an organization, including senior leadership and cross-functional teams
Experience coordinating and managing multiple projects and initiatives simultaneously
Demonstrated ability to build, lead and direct cross-functional teams through a strategic planning process to meet business goals
In-depth knowledge of Medicare products, regulations, and/or star ratings
Excellent communication, facilitation, and presentation skills
Ability to navigate ambiguity in a complex and matrixed environment
Strategic critical thinking skills, with a high level of curiosity and openness to change
Proven leadership ability is exemplified by a capacity to think strategically and implement tactically to consistently deliver results, well-developed skills in diplomacy and collaboration
Knowledge of computers including Microsoft Office (Word, Excel, PowerPoint, SharePoint) and reporting, database, analytics applications
Strong analytical skills
Preferred
Three (3) years of Medicare Stars CAHPS, HOS, HEDIS or similar experience
One (1) year of experience collaborating with provider quality improvement on behalf of a managed care organization
Experience with analytics in a healthcare setting
Benefits
Health
Time off
Retirement planning
Continuous learning opportunities
Company
HealthPartners
HealthPartners, an integrated health care organization providing health care services and health plan financing and administration, was founded in 1957 as a cooperative.
10001+ employees
H1B Sponsorship
HealthPartners 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 (26)
2023 (41)
2022 (37)
2021 (44)
2020 (52)
Funding
Current Stage
Late StageTotal Funding
$116M2020-05-07Debt Financing· $110M
2016-05-02Grant· $6M
Leadership Team
Penny Cermak
Executive Vice President and Chief Financial Officer
William Frey II
Research Director, Center for Memory & Aging, Neurosciences
Recent News
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2023-01-23
2022-12-07
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