Description
Purpose:UPMC Health Plan's Medicare/SNP STARS department is seeking a Senior Manager!
The scope of this position includes the quality improvement of all aspects of both care and service delivered in all settings related to Medicare members. This position is directly responsible for ongoing improvements in the CMS STAR ratings for all Medicare products. Manages strategic planning, operationalization, implementation, and monitoring of interventions/programs
Responsibilities:
Responsibilities:
• Responsible for operationalizing, implementing, and monitoring interventions and programs as well as process improvement projects.
• Works with key stakeholders across UPMC to drive improvement efforts and ensure alignment to Medicare STARs department’s strategic goals.
• Develop expertise in the CMS Medicare STARs program and serve as a SME to other departments across UPMC.
• Responsible for the implementation of CMS Medicare STARs program. Including monitoring and implementing changes in CMS Medicare STARs program regulations. And identifying proactive strategies in anticipation of program changes.
• Ability to work in a face-paced environment, manage several projects and programs, and take initiative to identify opportunities for quality improvement.
• Produces and presents management reports related to the CMS Medicare STARs program status.
• Works with key stakeholders across UPMC to drive improvement efforts and ensure alignment to Medicare STARs department’s strategic goals.
• Develop expertise in the CMS Medicare STARs program and serve as a SME to other departments across UPMC.
• Responsible for the implementation of CMS Medicare STARs program. Including monitoring and implementing changes in CMS Medicare STARs program regulations. And identifying proactive strategies in anticipation of program changes.
• Ability to work in a face-paced environment, manage several projects and programs, and take initiative to identify opportunities for quality improvement.
• Produces and presents management reports related to the CMS Medicare STARs program status.
Qualifications
- A bachelor's degree in a health related field required;
- Master's preferred (extensive related experience considered)
- Minimum five (5) years of experience in quality improvement, clinical improvement strategies in a managed care environment.
- Experience with HEDIS, CMS requirements for quality and the CMS stars program preferred
- Management experience with varying levels of staff
- Well- developed analytical and problem solving skills with the ability to interpret and summarize clinical data.
- Experience with report generation, trending and improvement planning
- Excellent presentation skills, experience in leading management level meetings
- Strong project management skills required, as well as managing all tasks required to meet departmental and company business needs
- Proficiency in Microsoft Office, including Word, Power Point and Excel
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran
Total Rewards
More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life &emdash; because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.
Our Values
At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.
