LibertyHealth System
PROGRAM MANAGER for RISK ADJUSTMENT/QUALITY
LibertyHealth System - Wilmington, North Carolina, United States, 28412
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Overview
There's no place like Liberty Health
Come explore career opportunities with
Liberty Health , a dynamic leader in the healthcare industry. Join us!
We are currently seeking an experienced:
PROGRAM MANAGER for RISK ADJUSTMENT/QUALITY
JOB SUMMARY:
Accountable for the success of end-to-end Risk and Stars strategy and performance to include HOS, CAHPS, and HEDIS performance Knowing and understanding CMS regulations that govern the STAR Rating System Actively monitor changes to CMS or other regulatory guidelines impacting metrics, weighting and/or measurement of STAR metrics and plan enhancement actions to accommodate those changes Leading and implementing quality improvement initiatives aimed at enhancing STAR ratings from design to completion Collaborating with operational leaders to analyze needs, develop strategies, and monitor program performance Manage vendor relationships to increase quality and efficiencies for Risk Adjustment/HEDIS strategies Direct and oversee Risk Adjustment strategy and internal/external audit preparation Lead, coach, and instruct process owners in optimizing programs through Member and Provider Engagement initiatives Lead and implement performance analytics to identify areas of opportunity and measure performance Monitor, track, and communicate STARS-related Key Performance Indicator (KPI) outcomes, to demonstrate and elevate the effectiveness of the plan's STAR Rating Program. JOB REQUIREMENTS:
Bachelor's Degree, required A minimum of 3 years Medicare Stars experience, preferred Experience with analytics in a healthcare setting Experience working with regulatory agencies and compliance environment with practical knowledge of Medicare regulations Experience coordinating and managing multiple projects and initiatives simultaneously Leadership experience: demonstrated ability to lead initiatives, projects, team members to accomplish successful outcomes. Advanced Microsoft Excel skills Must have valid state driver's license and auto insurance Must reside in North Carolina or be willing to relocate to the area Must be willing and able to travel to complete on-site visits with brokers, providers, and vendors Working knowledge of relevant federal and state regulations and requirements Prior experience in public speaking and conducting presentations Prior experience in the managed care industry Prior experience with medical, life insurance and dental product positioning Exceptional interpersonal skills
Visit www.libertycareers.com for more information. Background checks/drug-free workplace. EOE.
Come explore career opportunities with
Liberty Health , a dynamic leader in the healthcare industry. Join us!
We are currently seeking an experienced:
PROGRAM MANAGER for RISK ADJUSTMENT/QUALITY
JOB SUMMARY:
Accountable for the success of end-to-end Risk and Stars strategy and performance to include HOS, CAHPS, and HEDIS performance Knowing and understanding CMS regulations that govern the STAR Rating System Actively monitor changes to CMS or other regulatory guidelines impacting metrics, weighting and/or measurement of STAR metrics and plan enhancement actions to accommodate those changes Leading and implementing quality improvement initiatives aimed at enhancing STAR ratings from design to completion Collaborating with operational leaders to analyze needs, develop strategies, and monitor program performance Manage vendor relationships to increase quality and efficiencies for Risk Adjustment/HEDIS strategies Direct and oversee Risk Adjustment strategy and internal/external audit preparation Lead, coach, and instruct process owners in optimizing programs through Member and Provider Engagement initiatives Lead and implement performance analytics to identify areas of opportunity and measure performance Monitor, track, and communicate STARS-related Key Performance Indicator (KPI) outcomes, to demonstrate and elevate the effectiveness of the plan's STAR Rating Program. JOB REQUIREMENTS:
Bachelor's Degree, required A minimum of 3 years Medicare Stars experience, preferred Experience with analytics in a healthcare setting Experience working with regulatory agencies and compliance environment with practical knowledge of Medicare regulations Experience coordinating and managing multiple projects and initiatives simultaneously Leadership experience: demonstrated ability to lead initiatives, projects, team members to accomplish successful outcomes. Advanced Microsoft Excel skills Must have valid state driver's license and auto insurance Must reside in North Carolina or be willing to relocate to the area Must be willing and able to travel to complete on-site visits with brokers, providers, and vendors Working knowledge of relevant federal and state regulations and requirements Prior experience in public speaking and conducting presentations Prior experience in the managed care industry Prior experience with medical, life insurance and dental product positioning Exceptional interpersonal skills
Visit www.libertycareers.com for more information. Background checks/drug-free workplace. EOE.