Medicare STARS Program Manager
Bcidaho

Job Info

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Blue Cross of Idaho (BCI) has a new opportunity for a Medicare STARS Program Manager. This role implements and administers the Medicare STARS program across the enterprise, and is responsible for the planning, governance, and oversight of the successful delivery of the program. The work is carried out using high collaboration with multi-disciplinary teams, external vendors, providers, state and federal regulators.

This position reports to the Director, Medicare STARS Program. Hybrid schedule is supported in a mutually acceptable location in Idaho. #LI-Hybrid

To be considered for this opportunity:

Experience: 5 years' health-related, business process or related experience

Education: Bachelor's Degree or equivalent work experience (Two years' relevant work experience is equivalent to one-year college)

Preferred Qualifications:

• Extensive knowledge of CMS regulations and compliance expectations
  
• Experience in a managed care environment, with leadership in a matrixed environment
  

What your day may look like:

• Direct responsibility for ongoing policy development, interpretation, enforcement, and/or application analyses.
  
• Handles communications and decisions related to the Program and other functions, as applicable.
  
• Oversees mandates/initiatives related to Program initiatives, operations, financial settlements, membership, attribution, and reporting.
  
• Oversee Programs performance measurements and ensures action plans are in place, as needed.
  
• Identify opportunities for improvement using annual and prospective data sources. Presents conclusions and recommendations that detail which measures have the most opportunity for improvement including strategic interventions.
  
• Coordinate and support efforts to develop improvement plans for all lines of service.
  
• Present result of analysis and recommendations to management, steering committees, and/or impacted work teams.
  
• Manage vendors responsible for improvement related efforts or metric reporting.
  
• Evaluate program effectiveness by collecting and analyzing data in support of key performance metrics.
  
• Ensure that activities are in compliance with organizational policies and relevant external regulations. Ensure documentation of improvement plans and deliverables.
  
• Performs other duties and responsibilities as assigned.
  

Reasonable accommodations: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

This job has expired.