What are the responsibilities and job description for the Medicare Stars Member Experience Lead position at HMSA?
- 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.
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