Required skills & experience:
1. Medical Doctor Degree (MD) or Doctor of Osteopathic Medicine (DO) required.
2. Advanced degree, such as MBA, MHA, MPH, MMM, or a related field preferred.
3. Board Certified in a specialty approved by the American Board of Medical Specialists or the American Board of Osteopathy.
4. Ten (10) years of progressively more responsible experience in a healthcare environment.
5. Five (5) years of management or supervisory experience in healthcare strongly preferred.
6. Health care practice experience providing services to Medicare Advantage and Medicaid patients required.
7. Broad experience of the Medicare segment and an understanding of the overall Medicare stars program.
8. Must have experience on the health plan/payor side, not looking for provider-side experience.
What you need to know:
1. The senior-level role is responsible for providing medical leadership over the Senior Health Services team’s Medicare Stars program.
2. Responsible for continuous improvement of clinical HEDIS, Pharmacy, HOS, and CAHPS scores.
3. Work directly with medical leadership at contracted provider organizations to assist them in reaching their clinical goals.
4. Oversee the development and implementation of the strategic plan to achieve and retain 4.5 STARs for the HMO and PPO.
5. Opportunity to join an innovative, trailblazing company with industry-leading culture and benefits.
6. Monthly vehicle stipend, however, work is currently remote during this pandemic.