Medicare Stars Program Manager

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Job Summary
The Medicare Stars Program Manager is responsible for managing the day to day operations of the Medicare Stars Program. Under the strategic direction set by Department and Medicare Line of Business (LOB) leadership, this position drives performance of metrics through program enhancements, metrics analysis and alignment, and enterprise wide collaboration. Included in the scope of authority for this position is identifying and influencing timely deployment of adequate multi-functional resources to meet the performance targets through the integration of internal operations.

Essential Responsibilities

Program Management

Work to assure the Medicare Stars Program is aligned with the organization’s strategic plan.
Make formal and informal presentations and reports to all levels of the organization as needed, providing updates and other relevant information on the status the program.
Participate with external resources as identified that will support the evolution of the Stars program.
Integrate the program into departments’ standard work to create a path to achievement of metric performance through collaboration and technical support.
Act as a resource for internal staff and external partners as needed for problem solving and disseminate educational materials and other resources.
Participate in providing education for all staff concerning Stars strategy and impact.
Identify potential difficulties and/or barriers to project goals and take steps to mitigate or avoid them.
Assist in identifying synergy between Medicare Stars metrics and CCO metrics to maximize achievement with the most efficient deployment of CareOregon and network staff.
Participate in and manages special projects and activities as requested by the Department and LOB leadership.
Perform effective short and long-term program planning to ensure progressive and effective operations of the stars program based on evaluation and industry trends.
Analyze rules and regulations to determine the operational impact to the stars program and ensure proper implementation.

Data Coordination and Analysis

Perform ongoing analysis of data and benchmark performance relevant to Stars metrics, and work with internal teams to support effective actions to achieve objectives.
Maintain CareOregon Stars metrics scorecard through the development of tools and dashboards.
Collaborate with internal stakeholders to develop, produce, implement and maintain department and program dashboards and reporting tools that convey status star metrics for program management and evaluation Provide on-going support and coaching to staff in how to use Stars performance tool.
Identify and communicate data modifications, errors and/or difficulties to the vendor and internal IS staff.
Evaluate the performance of the program through on-going monitoring of quantitative and qualitative means.

Organizational Responsibilities

Perform work in alignment with the organization’s mission, vision, and values.
Support the organization’s commitment to equity, diversity, and inclusion by fostering a culture of open mindedness, cultural awareness, compassion, and respect for all individuals.
Strive to meet annual business goals in support the organization’s strategic goals.
Adhere to the organization’s policies, procedures, and other relevant compliance needs.
Perform other duties as needed.

Knowledge, Skills and Abilities Required
Possess a high degree of understanding concerning Health Plan Performance Measures, scorecard changes and technical specifications, as well as measurement payment timing and process
Program management skills, as well as skills in leading and implementing project tasks and activities to achieve goals within established timeline and budget
Ability to critically evaluate and interpret information gathered from the multiple sources
Well-developed analytical and problem-solving skills
Strong organizational skills; ability to manage multiple tasks
Strong verbal and written communication and presentation skills including ability to articulate concepts to staff, partners and stakeholders
Excellent consensus building skills
Ability to proactively communicate and collaborate with external and internal customers to analyze information needed and functional requirements
High competency with computer software programs, e.g. MS Outlook, Word, Excel, and PowerPoint
Technology proficiency, including ability to learn/query proprietary databases (e.g. QNXT)
Demonstrated ability to maintain a high degree of professionalism in working with CareOregon’s business partners
Ability to work independently and prioritize work to balance competing deadlines in a professional manner
Ability to work in an environment with diverse individuals and groups

Physical Skills and Abilities Required

Lifting/Carrying up to 10 Pounds

Pushing/Pulling up to 0 Pounds

Pinching/Retrieving Small Objects

Crouching/Crawling

Reaching

Climbing Stairs

Repetitive Finger/Wrist/Elbow/

Shoulder/Neck Movement

1-3 hours/day

0 hours/day

0 hours/day

0 hours/day

0 hours/day

0 hours/day

More than 6 hours/day

Standing

Walking

Sitting

Bending

Seeing

Reading

Hearing

Speaking Clearly

0 hours/day

0 hours/day

0 hours/day

0 hours/day

More than 6 hours/day

More than 6 hours/day

More than 6 hours/day

More than 6 hours/day

Cognitive and Other Skills and Abilities

Ability to focus on and comprehend information, learn new skills and abilities, assess a situation and seek or determine appropriate resolution, accept managerial direction and feedback, and tolerate and manage stress.

Education and/or Experience

Required:

Minimum 4 years’ related experience required, including minimum 2 years in health care quality assurance or quality improvement, program development, management, or coordination
Preferred:

Minimum 2 years’ experience in managed care and/or primary care or specialty clinic practice
Minimum 1 year working in Medicare managed care or Medicare policy

Working Conditions

Environment: This position’s primary responsibilities typically take place in the following environment(s) (check all that apply on a regular basis):
☒ Inside/office ☐ Clinics/health facilities ☐ Member homes

☐ Other_________________________________________

Travel: This position will include occasional required or optional travel outside of the workplace, in which the employee’s personal vehicle, local transit, or other means of transportation may be used.
Equipment: General office equipment
Hazards: n/a
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment

Veterans are strongly encouraged to apply.

Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Position Description »