Clever Care Health Plan · 17 hours ago
Star Programs Specialist (Bilingual Korean or Mandarin or Vietnamese)
Huntington Beach, CA
Full-time
Hybrid
Mid Level
$70K/yr - $75K/yr
3+ years expClever Care Health Plan is one of Southern California’s fastest-growing Medicare Advantage plans, dedicated to transforming healthcare for underserved communities. The Star Programs Specialist will assist in implementing member experience improvement strategies and work closely with various teams to enhance member services and quality improvement initiatives.
Health Care
Responsibilities
Engage providers through a focused, meaningful, educational approaches to proactively address member abrasion points
Drive providers to take an active role with the Clever Care Health Plan's quality improvement programs, and various health-centered incentives
Support process improvement in collaboration with management efforts
Collaborate with Customer Service Team and work to resolve escalated member incidents pertaining to Access to care, vendor, Rx and other issues
Facilitate fax or telephone call notification for providers targeted Stars measures
Create PowerPoint decks and other training materials for providers and staff
Monitors and ensures that key Stars/CAHPS activities are completed on time and accurately in order to present results to key departmental management and other Clever Care departments as needed
Collects and compiles the required documentation to maintain critical quality improvement functions
Participate in Stars activities, meetings, and discussions with and between other departments within the organization and or PCP’s, IPA’s and MSO’s
Assist in evaluating project/program activities and results to identify opportunities for improvement
Surfaces to Director any gaps in processes that may require remediation
Other duties as assigned
Qualification
Required
Bachelor's Degree or equivalent combination of education and work experience
Minimum three (3) years' experience in Healthcare
Minimum two (2) years' experience in health plan quality improvement, managed care or equivalent experience
Knowledge of CMS Star Programs, HEDIS, CAHPS
Valid driver's license, reliable transportation, and insurance required with clean driving record
Team player, leader, and individual contributor who can engage relevant parties cross-functionally, drive decision making, and as applicable, facilitate operational change
Proven track record of success implementing provider outreach and educational programs and/or projects and must be able to think critically to analyze performance and identify opportunities for improvement
Demonstrated solid business writing experience
Prior experience with project coordination and timelines
Demonstrated effective organizational skills
Excellent communication, writing, proofreading and grammar skills
Strong proficiency with MS Word, Excel, Power Point
Excellent organizational skills and attention to detail
Ability to interact with all levels of the organization, as well as external stakeholders
Superior meeting facilitation skills
Knowledge of HEDIS technical requirements
Understanding of CMS 5 Star program and requirements
Willing to travel locally to provider offices
Company
Clever Care Health Plan
Clever Care Health Plan is a healthcare company that provides health insurance for medicare services.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
unknown2021-11-01Series Unknown
Leadership Team
Karen Walker Johnson
Interim Chief Operations Officer
Khaliq Siddiq
Chief Medical Officer
Recent News
MedCity News
2025-10-30
Clever Care Health Plan
2025-08-29
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