State Licensed Quality Improvement Manager

Job Summary

A company is looking for a Manager, Stars and Quality Improvement Programs to lead quality performance initiatives for the Medicare Advantage population.

Key Responsibilities

• Provide strategic direction for Medicare Advantage quality initiatives focused on Part D Star Ratings and HEDIS medication measures
• Lead and develop a high-performing team of quality professionals, including staffing and performance management
• Collaborate with clinical and analytics teams to design strategies that improve medication-related outcomes and manage medication adherence interventions

Required Qualifications

• Active license as a Registered Nurse (RN), Licensed Practical Nurse (LPN), Pharmacist, or related clinical discipline (master's degree preferred)
• Minimum 7+ years of experience in healthcare quality improvement, particularly in Medicare Advantage and Stars performance programs
• Minimum of 3 years of experience managing or supervising staff
• Deep expertise in Part D Star Ratings, HEDIS medication measures, and CMS regulatory expectations
• Proven ability to design and execute data-driven quality initiatives that improve Stars metrics