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UCLA Health · 3 weeks ago

NCQA and CMS Star Rating Program Manager

Los Angeles, CA

Full-time

Hybrid

Mid, Senior Level

$71K/yr - $145K/yr

4+ years exp

UCLA Health is seeking an NCQA and CMS Star Rating Program Manager to lead initiatives for the Medicare Advantage Plan’s success in NCQA Health Plan Accreditation and CMS Star Ratings. This role involves managing programs for continuous survey readiness and compliance while fostering a culture of transparency and improvement within cross-functional teams.

Hospital & Health Care

Responsibilities

Lead the planning, implementation, and evaluation of programs to meet NCQA and CMS Star Ratings standards

Collect and prepare evidence to support survey readiness for NCQA Accreditation and CMS Star Ratings

Collaborate with teams to ensure alignment with organizational priorities and compliance with CMS/NCQA requirements

Develop and track clear goals, timelines, and deliverables for program success

Guide teams to maintain a culture of transparency, accountability, and continuous improvement

Identify and resolve program challenges proactively across departments

Use advanced project management tools to monitor progress and optimize resources

Report on program progress to senior leadership, ensuring goals are met and outcomes are achieved

Qualification

NCQA standards expertiseCMS Star Ratings expertiseProject management skillsMedicare Advantage operationsData analysis skillsMicrosoft Office proficiencyHealthcare data analyticsInterpersonal communicationCritical thinking

Required

A bachelor's degree in healthcare administration, public health, nursing, or related field and/or equivalent experience

A minimum of 4 years of related experience, required

Demonstrated subject matter expert of NCQA Health Plan standard and/or CMS Star Ratings

Knowledge of NCQA survey process and IRT systems

Knowledge of Medicare Advantage operations, CMS regulations, and health services program requirements

Knowledge and use of CAHPS, HEDIS, and HOS surveys and data measures

Proven experience managing cross-functional project with multiple stakeholders

Strong project management skills with the ability to develop execute complex program plans, manage timelines, and meet deadlines

Strong assessment and critical thinking skills

Subject matter expert of CMS Star Ratings and/or NCQA standards

Ability to analyze and interpret data, identify trends, and develop action plans for quality improvement

Excellent interpersonal, written and verbal communication skills, with the ability to effectively interact with all levels of the organization

Proficient in Microsoft Office Suite and project management software

Preferred

A master's degree in healthcare administration, business administration, or public health, highly desired

A Project Management Professional (PMP), preferred

Certified in Professional in Healthcare Quality (CPHQ), preferred

Experience with healthcare data analytics tool is a plus

Company

UCLA Health

Glassdoor3.9

For more than half a century, UCLA Health has provided the best in healthcare and the latest in medical technology to the people of Los Angeles and throughout the world.

Founded in 1955

Los Angeles, CA, US

10001+ employees