Medicare STARS Program Manager

Medicare STARS Program Manager

Location: Remote in California

We have an opportunity to join the Alliance as the Medicare STARS Program Manager in the Medicare Administration Department.

Reporting to the Medicare Program Executive Director, this position:

• Performs program planning and design in support of development and implementation of the Alliance's STARS Program and performs ongoing operational program management
• Performs data analysis and reporting in support of STARS Program activities
• Works collaboratively with all Alliance departments and external stakeholders to maximize STARS ratings

ABOUT THE TEAM

The Medicare Administration team at the Alliance is small but mighty! Consisting of just a handful of talented and dedicated individuals, this team works cross-functionally to accomplish goals and objectives in support of building out and managing the Alliance's first D-SNP program, effective January 1, 2026. This team is dynamic and flexible, and values collaborative brainstorming, being thought partners for one another, and having a free exchange of ideas for best results and outcomes.

THE IDEAL CANDIDATE

• Thrives in a matrix management environment
• Proven track record of executing effective business strategies with the ability to execute and deliver results for Medicare Advantage and/or D-SNP programs
• Comprehensive program planning and development, management, and evaluation skills
• Demonstrated leadership skills with the ability to influence and motivate team members and peers to achieve program goals and objectives
• Demonstrated skill in critical thinking, with the ability to interpret complex Medicare requirements and implement them into business operations
• Champions change management to adopt new programs, policies & processes for seamless integration with current operations
• Excellent project management and interpersonal skills with emphasis on collaboration
• Excellent written and verbal communication and presentation skills
• Master's degree in Business, Health Administration, Public Policy or a related field
• Experience working with Medi-Cal products

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description and list of requirements click here

• Knowledge of:
• Principles and practices of Medicare managed care operations and related regulations
• CMS D-SNP STARS Rating System
• Complex practices, issues, and theoretical principles related to Medicare Advantage or D-SNP, including the market and regulatory environment
• Principles and practices of program development, implementation, management, and evaluation
• Research, analysis, and reporting methods
• Ability to:
  • Communicate STARS Rating System requirements and their impacts on Alliance operational systems
  • Develop and implement tactics based on the overall STARS strategy
  • Work effectively with cross-functional teams and build strong relationships with stakeholders
  • Demonstrate strong analytical skills, accurately collect, manage and analyze data, identify issues, offer recommendations and potential consequences, and mitigate risk
  • Manage multiple projects simultaneously, organize work, and achieve goals and timelines
• Education and Experience:
  • Bachelor's degree in Business, Healthcare Administration, Public Policy, or a related field
  • A minimum of eight years of experience in a managed care setting which included a minimum of five years of experience in Quality Improvement program/project management and a minimum of three years of experience working with the CMS D-SNP STARS Rating System (a Master's degree may substitute for two years of the general managed care experience); or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area

Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.