As a STARs Lead for New York and New Jersey with Aetna, you will report to the Vice President in the Medicare segment for New York and New Jersey. You will work with the Aetna national strategy team to ensure that national strategies are supporting New York /New Jersey STARs outcomes. Furthermore, you will develop strategies in the market to support achieving consistently high STARs ratings and serve as the local expert/resource to the local team regarding STARs/Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) programs. Also you will establish local market execution plans for STARs strategies and lead the execution of these strategies.
Additional responsibilities of the STARs Lead include:
- Engage with national, local clinical and HEDIS teams to ensure that clinical and HEDIS policies and processes are performed in a way that leads to STARs success in New York and New Jersey
- Understand the details of the CAHPS survey processes and work with the national and local teams to design and implement actions that drive consistently strong CAHPS results
- Utilize the various customer service reporting tools to identify issues and opportunities for improvement and work to ensure these systemic issues are resolved
- Collaborate with the Provider Engagement Management team and RNPM team to drive improved HEDIS and CAHPS results associated with each of our value-based providers
- Work closely with the national service operations team and the New York and New Jersey Directors of Operations to ensure that member satisfaction issues are identified and resolved quickly
- Present and train on STARs related matters both internally and externally and to various levels of individuals
This role will support the New York (NY) and New Jersey (NJ) markets.
- At least 5 years of STARs/HEDIS and/or CAHPS experience in managed care
- Master's degree
- Success in leading cross-functional initiatives in a managed care setting
- Experience establishing and implementing new strategies to promote results
- Demonstrated ability to utilize data to identify issues and drive performance
- Experience in a managed care service operations role
- Excellent presentation and communication skills; prior training-related experience ideal
- Develop and foster strong internal and external relationships with senior level executives and junior level employees
- Desire and capability to both create strategy and execute tactically
- Ability to advocate effectively for internal support and change
- Experience in management consulting, project consulting, business process consulting, financial strategic analysis, mergers and acquisitions, strategic business planning, and/or risk management consulting
Bachelor's degree from an accredited college or equivalent work experience is required
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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