Senior STARS Consultant - Remote

This position serves as the functional liaison between the Intake team and operations teams, supporting Medicare, and Star Ratings related business initiatives. Responsibilities include reviewing project scope, supporting business needs throughout the delivery cycle, and managing production and/or system change requests to deliver enterprise initiatives. The role researches and analyzes business impacts against project scope and supports effective project delivery for medium-complexity initiatives that may span multiple business functions. Additionally, the position facilitates communication of changes, enhancements, and operational updates to impacted business units to support successful implementation and business outcomes., Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.

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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC’s Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to “candidate home” to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,

Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

• Bachelor’s degree
• 5 years of healthcare industry or health insurance work experience
• Previous experience with Medicare
• Strong written and oral communication skills
• Organizational skills, including ability to prioritize tasks.
• Presentation skills and executive presence
• Experience with interacting successfully with senior management and staff of all levels across multiple departments
• Analytical thinking, and problem-solving skills
• Business acumen and project / program management skills

Preferred Job Qualifications:

• Demonstrated experience supporting or leading Medicare Advantage Star Ratings initiatives with measurable quality improvement outcomes.
• Deep understanding of HEDIS measures, quality reporting methodologies, and strategies used to improve Star Ratings performance.
• In-depth knowledge of Medicare Advantage products, CMS regulations, and the Medicare regulatory environment.
• Experience utilizing dashboards, scorecards, and performance reporting tools to identify trends, gaps, and opportunities for intervention.
• Experience with Inovalon, Cotiviti, or other quality measurement and HEDIS platforms.
• MBA, MPH, MHA, or related master’s degree with demonstrated analytical, strategic, and problem-solving capabilities.
• Experience supporting healthcare quality, operational, and performance improvement initiatives.
• Working knowledge of SQL and healthcare data analysis methodologies.
• Vendor oversight and management experience.

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii .

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!