Campus Pride Jobs

We are seeking an experienced and highly motivated Project Manager to lead initiatives that support and enhance the Medicare Advantage Star Ratings solutions and services. This individual will oversee cross-functional projects, work closely with various clients and teams (analytics, product, operational, IT, etc.), and ensure alignment with regulatory requirements, quality measures, and strategic goals aimed at supporting clients in Star Rating improvements. The ideal candidate will possess a deep understanding of Medicare Advantage plans, the Star Ratings system, and project management best practices. Key Responsibilities: * Quality Star Solution Program Management: Lead and manage client projects that directly impact the improvement of Medicare Advantage Star Ratings, focusing on the delivery of analytical, member activation, and consulting solutions. * Cross-functional Collaboration: Work with key stakeholders and clients across analytics, IT, compliance, marketing, and member services teams to ensure alignment and timely execution of initiatives impacting Star performance. * Data Analysis & Reporting: Coordinate the collection and analysis of data related to client performance reporting and support clients in monitoring Star performance, identifying trends, and developing reports that track progress against goals. Ensure that project milestones align with data-driven insights. * Quality Improvement Initiatives: Oversee projects designed to improve performance on key Star Ratings measures such as member satisfaction, clinical quality, care coordination, and health outcomes. * Regulatory Compliance: Ensure that all projects are compliant with CMS guidelines and regulations related to Star Ratings and Medicare Advantage plans. * Process Optimization: Drive process improvements and efficiency in Star solutions and product operations. * Project Planning & Execution: Develop detailed project plans, including timelines, resource allocation, and risk management strategies. Lead project teams to deliver projects on time, within scope, and on budget. * Stakeholder Communication: Regularly communicate project status, updates, and risks to senior management and other stakeholders, ensuring alignment on project goals. * Training & Education: Provide training and guidance on Star Ratings-related solutions and services to team members and stakeholders to ensure understanding, successful execution and growth. Qualifications: * Education: Bachelor's degree in Healthcare Administration, Business, or a related field. Master’s degree is a plus. * Experience: * Minimum of 5 years of experience in project management, preferably within the healthcare industry. * At least 3 years of experience working with Medicare Advantage Star Ratings or in a similar quality performance role. * Proven track record of managing cross-functional projects and teams in a healthcare setting. * Skills: * Strong understanding of the Medicare Advantage program and CMS Star Ratings framework. * Expertise in project management tools and methodologies (e.g., Agile, Waterfall, MS Project, JIRA). * Data-driven mindset with strong analytical skills to interpret complex data related to healthcare quality metrics. * Excellent communication, organizational, and leadership skills. * Ability to manage multiple projects simultaneously while adhering to deadlines and regulatory requirements. * Knowledge of CMS regulations and compliance requirements related to Medicare Advantage. * Certifications: * Project Management Professional (PMP) certification or Lean/Six Sigma certification a plus. Convey Health Solutions: is a healthcare technology and services company that specializes in providing integrated solutions for government-sponsored health plans, including Medicare, Medicaid, and commercial plans. The company focuses on enhancing the administration, compliance, and member engagement of health plans, offering scalable and flexible solutions that support health plan operations. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Convey Health Solutions, Inc.

Remote - Pareto