Medicare Stars Member Experience Lead

HMSA
United States, Hawaii, Honolulu
818 Ke’eaumoku Street (Show on map)
Nov 04, 2024
Monitors member experience indicators and identifies opportunities for improvement. Serves as subject matter expert on Medicare CAHPS performance indicators and trends. Leads the development of data collection and reporting methods to monitor member experience and Medicare CAHPS performance. Monitors and analyzes member experience indicators and Medicare CAHPS outcomes to ensure goals, objectives, outcomes are met. Monitors for adverse trends, performs root cause analysis, recommends process improvement modifications and corrective actions. Works within HMSA, and with BCBSA, providers and vendors to review best practices, programs, and processes for improvement opportunities. Responsible for bringing forward recommendations to the Stars leadership team. Leads the development and implementation of short-term and long-term strategies to ensure we meet health plan Medicare CAHPS goals. Champions a blend of quality improvement methodologies as the framework for supporting member experience initiatives. Works with internal and external stakeholders to develop and implement initiatives that make effective use of resources. Manages priorities, resource constraints, project issues and other factors to ensure that timelines and deliverables are understood and achieved. Ensures that quality improvement processes and documentation support CMS Medicare Star Ratings guidelines and requirements. Acts as the lead of Medicare member experience initiatives. Collaborates with cross-departmental business leaders and external partners to achieve common goals. Provides Medicare CAHPS education and to the whole organization and external partners. Provides Medicare CAHPS performance reporting to all levels of staff including executive leadership. Leads and/or participates in internal and external activities, workgroups, meetings, etc. that support Medicare CAHPS performance. Develops strong business partnerships with key areas throughout the organization and external partners to continually improve Medicare CAHPS performance. Seeks opportunities to support Medicare CAHPS performance through external provider programs (e.g., Payment Transformation, Advanced Hospital Care, value-based payment arrangements, etc.) Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid