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Medicare STARS Program Manager - West Columbia, United States - VALID8 Financial
Description
General Purpose:
The individual holding this position is required to support and demonstrate their commitment to the Longevity Health Plan Statement of Purpose, which is: To improve the health and quality of life of nursing home residents by caring for their unique medical, social, and emotional needs.
The Medicare Stars Program Manager is responsible for managing projects to support the Medicare Stars strategic initiatives at LHP and partner Stars related quality metrics.
The Program Manager works closely with the Director, Medicare Stars, Clinical Leadership, Finance, Compliance, Operations and IT to identify and to implement strategies to assure compliance with performance improvement requirements both set by the organization and by CMS.
The Program Manager will lead workgroups and projects designed to improve/maintain the Medicare Star ratings at LHP as well as our Partner quality metrics tied to Stars measures.
Key Tasks and Responsibilities:
The position requires someone with strong performance improvement and analytical capabilities, project/program management discipline, experience collaborating across teams, and a passion for improving the health and quality of life of nursing home residents.
Lead assigned projects while maintaining all project management information including timelines, resources, issues, scope, and other related project activities.
Work with Stars Program leaders to develop and execute Stars-focused roadmap that defines the path to operationalize specific actions which are repeatable, measurable, and cost-effective.
Monitor process of the Stars Program strategy, objectives, tactic, and initiatives to drive a year over year 4+ overall Star Ratings and meeting Program goals.
Assist in developing performance improvement strategies for the company with specific goals for Stars improvement in key functional areas.Develop standard reports, tracking tools, metrics to monitor vendor performance, Stars measures, tactics, and initiatives.
Report on Stars internally, inform Stars dashboard development and enhancements, trend performance over time.
Maintain Stars tracking dashboards for all contracts.
Facilitate Stars Steering Committee Meetings.
Contribute to evaluating performance improvement initiatives aligning with strategies.
Gather Stars reporting data, analyze CMS changes, collaborate with Stars leads to set strategic direction.
Assist with development of tools to enable success in measuring and forecasting Star performance.
Build strong relationships across teams.
Collaborate in building materials, analysis, reports, and presentations for Committees, performance meetings, trainings, newsletter, etc.
Performs other related duties as assigned.
Valid state driver's license with a good driving record and proof of automobile insurance required.
Auto liability insurance coverage per minimum required by home state.
Education and Training:
Knowledge and Experience:
5 years of program management experience.
3 years program management experience in a Medicare Stars program, 2 years needing to be with a Special Needs Plan.
Strong knowledge and 3 years of experience working with CMS Stars Ratings measures including HEDIS, CAHPS, PQA/Pharmacy, HPMS, HOS, Operations, and CMS Display measures.
Intermediate or higher level of proficiency with Microsoft Word, Excel, Outlook, and PowerPoint.5 years of experience working in a team-oriented, collaborative environment.
Excellent verbal communication and interpersonal skills.
Proven success in building and maintaining positive relationships.
Ability to influence and persuade people to collaborate and execute toward a common goal.
Strong organization and documentation, attention to details, ability to handle multiple projects and tasks simultaneously, time management meeting deadlines, even under pressure.
Ability to think analytically to resolve issues; solution-focused mindset; creative, innovative, and compliance thinker.Company Overview:
Founded in 2018, Longevity Health started as an Institutional Special Needs Plan (ISNP), a type of Medicare Advantage health plan that addresses significant unmet needs of long-term institutionalized members who reside in nursing homes.
Through rapid growth from 2018 to 2022, we expanded our market footprint and currently offer ISNP Medicare Advantage plans in Colorado, Florida, Illinois, Michigan, New Jersey, New York, and North Carolina.
In 2023, we expanded our service offerings to the broader health plan market.In addition to our existing markets where we are both the ISNP and the care management team, we are now partnering with National Carriers on their offered ISNP plans in Ohio, Pennsylvania, upstate New York, Georgia, South Carolina, and Texas, with implementations in progress for several other additional US states.
This allows us to utilize our core skills of supporting clinical post-acute needs of this vulnerable senior population Currently 13 markets and expanding rapidly.
Company Disclaimers:
Longevity Health is an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.
It is the policy of Longevity Health to follow Federal and / or State regulations surrounding COVID vaccinations.While CMS guidelines have been relaxed, there are some LHP facilities which will still require staff be vaccinated in an effort to protect the health of the members / patients we serve.
If your assigned location(s) require all staff to be fully vaccinated, you are required to obtain and / or provide documentation related to your COVID vaccination.
To confirm whether your assigned location(s) require COVID vaccinations, please refer to the Facility Guide Job Aid located on Longevity Health Plan's intranet site.
The Company will engage in an interactive process with individuals who cannot be vaccinated for medical or sincerely held religious beliefs to determine if a reasonable accommodation can be made.
While an exemption/accommodation may be initially granted, if at any time during employment, it is determined that an exemption/accommodation that has been granted is no longer considered a reasonable accommodation, it can result in employment with the Company ending.
Candidates must meet the Company's hiring criteria which include a pre-employment background and drug screening.Longevity Health offers a competitive compensation and benefits package which includes medical, dental, vision, short and long-term disability, life insurance, and 401(k).
Submission of false information during the application process may result in immediate termination of employment without notice.Apply for this job
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