Quality STARS Specialist

Job Summary

Quality STARS Specialist, a full-time remote position, is responsible for supporting a clinical health plan's CMS Star Ratings performance by monitoring quality measures, analyzing data for actionable insights, and collaborating with various teams to improve care delivery and member experience.

Key Responsibilities

• Monitor and report on CMS Star Ratings measures, identifying performance gaps and recommending interventions
• Assist in quality improvement initiatives and coordinate outreach campaigns to close care gaps
• Ensure compliance with CMS requirements and support regulatory audits and documentation

Required Qualifications

• Bachelor's Degree required; Master's Degree preferred
• 2-3 years of experience in a CMS STARs role and managing STARs data
• 5-7 years in health plan quality within a managed care organization preferred
• Familiarity with quality improvement methodologies and regulatory standards preferred
• Certification in healthcare quality or equity (e.g., CPHQ, Lean Six Sigma) preferred