"Alerted.org

Description

The NCQA and CMS Star Rating Program Manager will lead

initiatives to drive the Medicare Advantage Plan's success in NCQA Health Plan

Accreditation and CMS Star Ratings. This role involves managing programs to

maintain continuous survey readiness, meet NCQA standards, and ensure CMS

compliance. Working with cross-functional teams, you'll foster a culture of

transparency, accountability, and continuous improvement.

Key Responsibilities:

+ Lead the planning, implementation, and evaluation of programs to meet NCQA and CMS Star Ratings standards.

+ Collect and prepare evidence to support survey readiness for NCQA Accreditation and CMS Star Ratings.

+ Collaborate with teams to ensure alignment with organizational priorities and compliance with CMS/NCQA requirements.

+ Develop and track clear goals, timelines, and deliverables for program success.

+ Guide teams to maintain a culture of transparency, accountability, and continuous improvement.

+ Identify and resolve program challenges proactively across departments.

+ Use advanced project management tools to monitor progress and optimize resources.

+ Report on program progress to senior leadership, ensuring goals are met and outcomes are achieved.

Salary Range: $70,900 - $145,000/annually

_Note: This position is a flexible-hybrid role that requires one-day a week on-site in Los Angeles, CA._

Qualifications

We are seeking a talented, detail-oriented individual with:

Required:

+ A bachelor's degree in healthcare administration, public health, nursing, or related field and/or equivalent experience

+ A minimum of 4 years of related experience, required

+ Demonstrated subject matter expert of NCQA Health Plan standard and/or CMS Star Ratings

+ Knowledge of NCQA survey process and IRT systems

+ Knowledge of Medicare Advantage operations, CMS regulations, and health services program requirements

+ Knowledge and use of CAHPS, HEDIS, and HOS surveys and data measures

+ Proven experience managing cross-functional project with multiple stakeholders

+ Strong project management skills with the ability to develop execute complex program plans, manage timelines, and meet deadlines

+ Strong assessment and critical thinking skills

+ Subject matter expert of CMS Star Ratings and/or NCQA standards

+ Ability to analyze and interpret data, identify trends, and develop action plans for quality improvement

+ Excellent interpersonal, written and verbal communication skills, with the ability to effectively interact with all levels of the organization

+ Proficient in Microsoft Office Suite and project management software

Preferred:

+ A master's degree in healthcare administration, business administration, or public health, highly desired

+ A Project Management Professional (PMP), preferred

+ Certified in Professional in Healthcare Quality (CPHQ), preferred

+ Experience with healthcare data analytics tool is a plus

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.