Director - CAHPS

The Enterprise Clinical Stars Leader works across the Bright Health organization to define, assign, and oversee best-in-class member experience activities and performance for Medicare Advantage Plans. This individual is accountable defining best-in-class programs and targets, assigning accountability throughout the organization, overseeing CAHPS performance. This role will collaborate and partner with multiple stakeholders across the enterprise. In sum, this individual works with functions across the enterprise to develop, maintain, own, and execute strategies to improve overall Stars performance.

ROLE RESPONSIBILITIES

1. Leads, develops, and executes CAHPS and Operational Star strategies to improve measure level ratings across Bright Health Stars Medicare contracts
2. Collaborates with the Bright Health Medicare teams, regional and local health plan business leaders to improve overall CAHPS & Operational Star ratings for Medicare products
3. Monitor and evaluate initiatives, track progress, and adjust strategy to achieve organizational goals
4. Act as the Bright Health CAHPS and Operations Star program expert for both internal and external stakeholders
5. Supports all Star-related initiatives and activities across multiple business lines
6. Responsible for developing and operationalizing both national and market specific CAHPS and Operational strategies to ensure stars success
7. Directs and prioritizes activities that ensure we achieve our overall Stars objectives
8. Monitor historical and current data trends in order to make recommendations and predictions
9. Lead the organization to drive innovative initiatives that address low performing measures
10. Drives continuous improvement through a holistic and well-run performance improvement process.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Bachelor’s degree in Health-related field or equivalent work experience
• Five (5) years leadership experience with three (3) years of leading and directing MA Star Ratings strategy, achieving 4-Star ratings
• Five (5) years of managing complex, highly matrixed projects
• Five (5) years of experience working with HEDIS, CAHPS, HOS, and all Star Ratings measures
• Five (5) years of vendor management, oversight, and customer/relationship building
• Advanced proficiency with Microsoft Office Suite (Word, PowerPoint, Excel)

PROFESSIONAL COMPETENCIES
• Proficiency in interpreting results and formulating recommendations/action plans;
• Ability to research and analyze state/federal regulations related to health insurance and healthcare;
• Demonstrated skills in critical thinking, problem-solving, and the analysis, interpretation, and evaluation of complex information;
• Demonstrated ability to work independently;
• Excellent interpersonal, cross-functional coordination and communication skills.
• Strong project management skills;
• Strong verbal, writing and presentation skills;
• Computer skills: Microsoft Word; Excel; PowerPoint; and database software.
• Strong communication, time management and organization skills
• Demonstrated success in running and managing many projects at one time
• Demonstrated success in supporting internal clients and departments

WORK ENVIRONMENT
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.

 

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We’re Making Healthcare Right. Together.

We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:

 

Focusing on Consumers
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.

 

Building on Alignment
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.

 

Powered by Technology

We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.

 

          

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As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.