Medicare STAR

6 hours ago

Huntington Beach, California, United States Verda Healthcare Full time

Company Description

Verda Healthcare is a newly launched Medicare Advantage Plan led by a purpose-driven team of experienced healthcare professionals. The company is committed to ensuring healthcare is accessible and equitable for all individuals. Verda Healthcare focuses on serving individuals aged 65 and older, especially those in underserved ethnic communities, including Asian-American, Hispanic-American, and Arab-American populations across the United States.

Role Description

This is a full-time, on-site role located in Huntington Beach, CA, for a Medicare STAR & RAF Director. The Medicare STAR & RAF Director will oversee STARs and Risk Adjustment initiatives to ensure compliance and improve outcomes. Key responsibilities include analyzing and implementing performance improvement strategies, collaborating with internal teams and external stakeholders, driving sales strategies, managing projects to enhance the Medicare STAR program, and conducting training sessions to ensure program success.

Qualifications

  • Strong analytical skills to assess performance data and identify areas for improvement
  • Experience in sales within the healthcare industry
  • Proven background in the healthcare industry and familiarity with Medicare programs
  • Ability to deliver effective training and education related to program initiatives
  • Project management skills for overseeing and implementing strategic plans
  • Strong communication and leadership skills
  • Bachelor's degree in Healthcare, Business Administration, or related field; advanced degree preferred
  • Experience with Medicare Advantage

What Sets You Apart

  • Master's Degree in Health Administration preferred
  • Demonstrating in-depth clinical data management experience
  • Leading multidisciplinary teams in clinical data operations
  • Managing large-scale quality improvement initiatives
  • Communicating technical insights to non-technical audiences
  • Developing frameworks for improving data reliability
  • Understanding regulatory compliance in Medicaid and Medicare

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