Role OverviewThe Associate Principal, Stars Consulting Center of Excellence serves as both a strategic advisor and hands-on subject matter expert, leading complex Medicare Advantage performance improvement engagements for health plan clients nationwide. This role combines executive-level consulting, business development, project leadership, and deep technical expertise across Medicare Stars measures.
What You Will Do
Lead and personally deliver Medicare Stars consulting engagements across CAHPS, HEDIS, HOS, medication adherence, and operational performance measures. Conduct detailed measure-level analyses and develop actionable recommendations that drive quality and Stars performance improvements.
Why It Might Be a Fit
Success in this role requires the ability to translate complex CMS regulations and Stars methodologies into actionable strategies that improve performance across CAHPS, HEDIS, HOS, medication adherence, and operational measures while identifying opportunities to expand Press Ganey's impact within client organizations.
Requirements
- 10+ years of experience in government-sponsored healthcare, including Medicare Advantage and/or Medicaid.
- Direct accountability for Medicare Star Ratings, quality improvement, population health, or regulatory performance initiatives.
- Demonstrated success advising executive leaders on healthcare quality, Stars, and operational performance strategies.
- Experience leading complex, cross-functional initiatives with measurable business outcomes.
- Bachelor's degree required.
- Deep expertise in HEDIS, including NCQA measure specifications, claims data, supplemental data, ECDS reporting, audit processes, and performance improvement strategies.
- Strong understanding of Medicare Star Ratings methodology, including measure weighting, cut point movement, improvement measures, Categorical Adjustment Index (CAI), reward factors, and Quality Bonus Payment implications.
- Experience analyzing performance data and identifying opportunities to improve measure outcomes.
- Proficiency with Excel, SQL, and/or other analytics tools used to perform measure-level performance analyses.
- Advanced Microsoft Office skills, particularly PowerPoint and Excel.
- Exceptional executive communication, facilitation, presentation, and consulting skills.
- Proven ability to influence senior stakeholders and drive strategic decision-making.
- Strong analytical, quantitative, and problem-solving capabilities.
- Ability to thrive in a fast-paced, client-facing consulting environment.
- Deep understanding of Medicare Advantage market dynamics, quality measurement, and evolving regulatory requirements.
Benefits
- Competitive benefits package
- Discretionary bonus or commission tied to achieved results
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