Bcidaho Hiring for Medicare STARS Program Manager – R2282 at MERIDIAN, Idaho Full Time

This job was posted by https://idahoworks.gov : For more information,
please see: https://idahoworks.gov/jobs/1989422 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.