About the Role
The Stars Program Manager is responsible for developing and executing a strategy to improve the CMS Stars rating performance for Santa Clara Family Health Plan. This role serves as a critical resource and subject matter expert in supporting, monitoring, managing, and driving strategic projects, interventions, and initiatives for the organization's Medicare Star Rating program.
This is a highly collaborative role that partners with internal teams across the company, external vendors, and healthcare providers to ensure our programs are achieving our goals. The role uses a variety of data sources to determine performance across current and emerging STARS measures, identify insights and opportunities for performance improvements, and share these findings with stakeholders to drive continuous improvement. This position reviews and accurately interprets complex regulatory documents, including STARS measure specifications from CMS and measure stewards. This position will lead and present material at internal and external meetings, develop and conduct training on STARS-related topics, assist in regulatory comment development, help drive goal setting, help prioritize interventions, and develop/maintain STARS Program-related documents.
- Bachelor’s Degree in Management, Business, Healthcare, or a related field, or equivalent experience.
- Minimum three years of experience with quality improvement in health related setting, including performing root cause analysis, Plan Do Study Act methodology and monitoring/analyzing improvement, program development.
- Knowledge of Medicare principles and practices with emphasis in quality improvement.
- Proven ability to design and execute strategic plans for continuous improvement initiatives.
- Medicare Stars experience.
About the Company
Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and SCFHP DualConnect (HMO D-SNP) health care plans.