Medicare Stars Owner

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

The Medicare Stars Owner will report to the Senior Director of Sales. This role will be responsible for developing and overseeing specific strategic and tactical initiatives to achieve and maintain a competitive Medicare star rating. This position will provide oversight to a cross-functional team responsible for developing measure-specific goals and detailed plans for achieving these goals.

Essential Functions

• Lead and Champion governance of a cross-functional Medicare Stars operating model, assigning responsibility accountabilities for Star performance across all measures, and convening a Steering Committee to guide strategy and break down organizational barriers to success

• Lead efforts to increase and maximize the Medicare Star ratings by developing short and long-term strategies, goals and objectives (with measurable outcomes) across applicable departments.

• Provide management with overall status reports related to month-over-month and year-over-year Stars performance, including any issues that may impact the organization.

• Develop and implement a member experience framework to embed into all Medicare-related programs-those explicit for Star, as well as other Medicare-focused efforts.

• Partner with analytical teams to determine measure-level targets for every Star measure, and develop a monitoring framework to create visibility of performance, risks, and opportunities in Star measure performance

• Convene stakeholders on budgeting to determine needed investment and programming areas.

• Interpret regulatory guidance from CMS on the future direction of Stars and partner with cross-functional partners (analytics, compliance, clinical/pharmacy departments) to ensure that long-term implications are being incorporated into organizational planning

• Manage business planning, budget, business continuity, risk management and operating model.

• Partner with cross-functional stakeholders to prioritize business and regulatory needs for Stars relative to technology enhancements/

• Develop and implement framework for Star vendor management, developing a rubric for standards and performance management for various vended interventions

• Hold self and others accountable to meet commitments.

• Ensure diversity, equity, and inclusion are integrated as a guiding principle.

• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.

• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.

• Other duties as assigned with or without accommodation.

Working Conditions and Physical Effort

• Work is normally performed in a typical office/hybrid/remote work environment.

Knowledge and Education

Required:

• BA or BS

Preferred/Desired:

• Master's Degree in MBA , Nursing, Healthcare Administration, Health Informatics

Experience

Required:

• 3-5 years of Medicare Stars experience.

• Knowledgeable in data collection, specifications, and key performance drivers of all Star Measures (HEDIS, HOS, PDE, HOS, CAHPS)

• Experience in member engagement and experience domains

Skills/Competencies

• Data driven, analytically minded

• Demonstrate Mass General Brigham's core brand principles of always listening, challenging conventions, and providing value.

• Strong aptitude for technology-based solutions.

• Ability to inject energy, when and where it's needed.

• Respect the talent and unique contribution of every individual, and treat all people in a fair and equitable manner.

• Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback.

• Be accountable for delivering high-quality work. Act with a clear sense of ownership.

• Bring fresh ideas forward by actively listening to and working with employees and the people we serve.