R.A. Wylan & Co. Inc.,
Career Center

Director, STARS (Medicare) HEDIS, NCQA

Location: Tampa, FL
Job Type: Direct Hire
Salary: $120,000.00 - $140,000.00
Date: 5/15/2018
Job ID: 02596481
Job Description
We are in search of a RN or Healthcare Administrator to manage the Medicare STARs across our client company’s Medicare Plans. To be considered you should be currently involved in leading a STARS program.

Here is what our qualified candidate looks like:
  • Experience in STARS and leading STARS Program.
  • 7+ years of managed care experience – Medicare
  • Knowledge of Center for Medicare/Medicaid Services, requirements for Special Needs Plans (SNP), Medicare Medicaid Plans (MMP) and NCQA oversight requirements preferred.  
  • Previous management experience.
  • Bachelor's degree in Nursing, Healthcare Administration or related field
  • Expert of Medicare Stars Program to ensure Healthcare Effectiveness Data and Information Set (HEDIS) and Stars objectives are met
  • Develop, manage and coordinate clinical and non-clinical HEDIS and Stars-related activities
  • Perform analysis of enterprise-wide data and practices to identify opportunities for improvement at the local and national level
  • Lead cross functional efforts to develop, deploy and manage reporting dashboard.
  • Ensure policies and procedures are compliant with NCQA and CMS guidelines
This position does have direct reports and reports to the VP of Quality.
Our client really prefers the qualified candidate has experience with NCQA oversight requirements in addition to project management, administration or operations experience.
Relocation offered. 20% or higher Performance Bonus in addition to competitive 6 figure salary. Our client offers a full comprehensive benefits package including full medical, PTO, 401K etc. Please email your resume along with best days and times to reach you to learn more.