Job summary
Job post source
This job is directly from Guidehealth
Job overview
The Manager, Stars and Quality Improvement Programs at Guidehealth leads Medicare Advantage quality improvement initiatives to enhance member outcomes and provider engagement.
Responsibilities and impact
The role involves managing quality initiatives like CMS Star Ratings, HEDIS®, and MIPS, overseeing audits, ensuring CMS audit readiness, leading performance improvement projects, managing a quality team, collaborating across departments, and reporting to leadership.
Compensation and benefits
The base salary ranges from $87,000 to $90,000 annually, with comprehensive benefits including medical, dental, vision, 401(k) with employer match, life and disability insurance, paid time off, parental leave, remote work flexibility, and professional development resources.
Experience and skills
Candidates need a bachelor's degree in nursing, public health, healthcare administration or related field, with 7+ years in healthcare quality improvement, strong knowledge of HEDIS®, MIPS, NCQA, CMS Star Ratings, audit experience, leadership skills, and preferred certifications like CPHQ.
Career development
Guidehealth offers professional growth through various learning and development resources to advance careers within a fully remote, supportive environment.
Work environment and culture
Guidehealth values accountability, continuous learning, collaborative innovation, inclusivity, and empathy, fostering a purpose-driven and supportive remote work culture.
Company information
Guidehealth is a data-driven healthcare company focused on affordable, high-quality care using AI and predictive analytics, operating remotely with a physician-led approach to improve patient and provider experiences.
Team overview
The candidate will manage and mentor the Quality and Performance Improvement team, collaborating with clinical, operational, analytics, compliance, and provider teams.
Job location and travel
This is a fully remote position requiring candidates to reside within a 90-minute drive of Metro-Atlanta, GA, with provided equipment and internet requirements.
Unique job features
The role offers unique opportunities to lead Medicare Advantage quality programs with a focus on CMS Star Ratings and HEDIS®, working in a fully remote setting with strong emphasis on data-driven quality improvement and cross-functional collaboration.
Company overview
Guidehealth is a healthcare technology company focused on improving patient outcomes through innovative digital solutions. They make money by offering a suite of products and services that streamline patient care, enhance data management, and provide actionable insights to healthcare providers. Founded with the mission to transform healthcare delivery, Guidehealth has established itself as a leader in the industry by leveraging cutting-edge technology to address the challenges faced by medical professionals and patients alike. Their commitment to advancing healthcare through technology has positioned them as a key player in the digital health landscape.
How to land this job
Tailor your resume to highlight your expertise in managing Medicare Advantage quality improvement programs, emphasizing your knowledge of CMS Star Ratings, HEDIS®, CAHPS®, and MIPS compliance.
Showcase your leadership experience in overseeing HEDIS® reporting and audits, including vendor coordination and data validation, as well as your ability to drive measurable improvements in medication adherence and member outcomes.
Apply through multiple platforms such as Guidehealth's official careers page, LinkedIn, and reputable healthcare job boards to maximize your application visibility.
Connect with current employees or managers in Guidehealth's quality improvement or Medicare Advantage divisions on LinkedIn; use ice breakers like commenting on recent quality initiatives Guidehealth has undertaken or expressing interest in their approach to value-based care models.
Optimize your resume for ATS by incorporating keywords from the job description such as 'CMS Star Ratings,' 'HEDIS audit,' 'quality improvement,' 'medication adherence,' 'NCQA,' and 'value-based contracting' to ensure it passes automated screenings.
Leverage Jennie Johnson's Power Apply feature to automate tailored applications, identify the best job portals for submission, and facilitate networking by finding relevant Guidehealth contacts, allowing you to focus your energy on interview preparation and skill enhancement.
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