Program Manager
The Judge Group Inc.

Location: REMOTE
Salary: $65.00 USD Hourly - $75.00 USD Hourly
Description:
Program Manager Sr

Position Overview: This role involves designing, developing, implementing, and evaluating programs aimed at improving CMS (Centers for Medicare & Medicaid Services) Star Ratings. The Program Manager Sr will oversee Medicare Star projects and programs, collaborating with leadership and cross-functional teams to advance strategic priorities. Responsibilities include assisting in the design process, implementation, and outcomes measurement to ensure programs meet market, provider, and member requirements. The role also involves resolving complex business issues, identifying business opportunities, and managing change effectively. The incumbent will work on program teams across the organization and manage programs with tight deadlines, serving as a liaison between multiple departments.

Key Responsibilities:

• Develop detailed strategies and workplans to influence operational change and performance for assigned Star measures.
• Utilize evidence-based and multi-component approaches to program strategy, design, and execution.
• Drive the development and documentation of design, requirements, and key milestones to support increased and sustained Star ratings.
• Maintain strategic relationships and partner with key internal and external resources to ensure market, member, and provider considerations are factored into the design, including vendor oversight.
• Support business decision-making processes to ensure capabilities, systems, and processes meet market expectations and explore alternative approaches.
• Manage ongoing program management work of multiple programs to ensure alignment with strategic solutions.
• Monitor and manage multiple metrics, perform data analysis, and evaluate each initiative.
• Continually update program or project plans, timelines, and deliverables while coordinating multiple subprocesses to expand and/or improve programs.
• Manage multiple communication plans in conjunction with leadership, including status and progress updates.
• Stay updated on changes in the healthcare marketplace, including CMS regulatory changes, to define successful measure performance.
• Perform other duties as assigned.

Preferred Qualifications:

• Bachelor's and/or master's degree in business, nursing, public health, health sciences, health promotion, or related field.
• Strong knowledge of CMS Star Ratings measures (such as NCQA HEDIS®, CAHPS, PQA/Pharmacy, HOS, Operations, and CMS Display measures) and experience with the Medicare population.
• Previous health plan experience.
• Experience in process improvement and driving clinical measures.
• Expertise in reducing health risk behavior.
• Experience working with diverse racial or ethnic groups and nations.

Required Skills and Experience:

• 5+ years of related professional experience. All relevant experience, including work, education, transferable skills, and military experience, will be considered.
• Demonstrated organizational relationship management skills.
• Ability to thrive in ambiguity.
• Strong critical thinking and problem-solving/conflict resolution skills.
• Excellent written and verbal communication skills with strong facilitation, negotiation, and presentation skills, adapting approach as needed.
• Attention to detail and time management skills.
• Self-motivated, ability to work independently, and demonstrated ability to work under tight time frames.
• Knowledge of the healthcare industry, payer business models, business segments, and products.
• Proven ability to handle various assignments in a fast-paced and complex business environment.
• Proven ability to define problems, collect and analyze data, establish facts, and draw valid conclusions.

Contact: jgohman@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com

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