Central California Alliance for Health
Medicare STARS Program Manager
Central California Alliance for Health, San Francisco, California, United States, 94199
We have an opportunity to join the Alliance as the Medicare STARS Program Manager in the Medicare Administration Department.
WHAT YOU'LL BE RESPONSIBLE FOR
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 managementPerforms data analysis and reporting in support of STARS Program activitiesWorks collaboratively with all Alliance departments and external stakeholders to maximize STARS ratingsABOUT 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 environmentProven track record of executing effective business strategies with the ability to execute and deliver results for Medicare Advantage and/or D-SNP programsComprehensive program planning and development, management, and evaluation skillsDemonstrated leadership skills with the ability to influence and motivate team members and peers to achieve program goals and objectivesDemonstrated skill in critical thinking, with the ability to interpret complex Medicare requirements and implement them into business operationsChampions change management to adopt new programs, policies & processes for seamless integration with current operationsExcellent project management and interpersonal skills with emphasis on collaborationExcellent written and verbal communication and presentation skillsMaster's degree in Business, Health Administration, Public Policy or a related fieldExperience working with Medi-Cal productsWHAT 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 regulationsCMS D-SNP STARS Rating SystemComplex practices, issues, and theoretical principles related to Medicare Advantage or D-SNP, including the market and regulatory environmentPrinciples and practices of program development, implementation, management, and evaluationResearch, analysis, and reporting methodsAbility to:
Communicate STARS Rating System requirements and their impacts on Alliance operational systemsDevelop and implement tactics based on the overall STARS strategyWork effectively with cross-functional teams and build strong relationships with stakeholdersDemonstrate strong analytical skills, accurately collect, manage and analyze data, identify issues, offer recommendations and potential consequences, and mitigate riskManage 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 fieldA 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
Zone 1 (Monterey, San Benito and Santa Cruz)
$111,319-$178,110 USD
Zone 2 (Mariposa and Merced)
$101,301-$162,094 USD
OUR BENEFITS
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 PlansAmple Paid Time Off12 Paid Holidays per year401(a) Retirement Plan457 Deferred Compensation PlanRobust Health and Wellness ProgramOnsite EV Charging StationsABOUT US
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.
WHAT YOU'LL BE RESPONSIBLE FOR
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 managementPerforms data analysis and reporting in support of STARS Program activitiesWorks collaboratively with all Alliance departments and external stakeholders to maximize STARS ratingsABOUT 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 environmentProven track record of executing effective business strategies with the ability to execute and deliver results for Medicare Advantage and/or D-SNP programsComprehensive program planning and development, management, and evaluation skillsDemonstrated leadership skills with the ability to influence and motivate team members and peers to achieve program goals and objectivesDemonstrated skill in critical thinking, with the ability to interpret complex Medicare requirements and implement them into business operationsChampions change management to adopt new programs, policies & processes for seamless integration with current operationsExcellent project management and interpersonal skills with emphasis on collaborationExcellent written and verbal communication and presentation skillsMaster's degree in Business, Health Administration, Public Policy or a related fieldExperience working with Medi-Cal productsWHAT 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 regulationsCMS D-SNP STARS Rating SystemComplex practices, issues, and theoretical principles related to Medicare Advantage or D-SNP, including the market and regulatory environmentPrinciples and practices of program development, implementation, management, and evaluationResearch, analysis, and reporting methodsAbility to:
Communicate STARS Rating System requirements and their impacts on Alliance operational systemsDevelop and implement tactics based on the overall STARS strategyWork effectively with cross-functional teams and build strong relationships with stakeholdersDemonstrate strong analytical skills, accurately collect, manage and analyze data, identify issues, offer recommendations and potential consequences, and mitigate riskManage 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 fieldA 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
Zone 1 (Monterey, San Benito and Santa Cruz)
$111,319-$178,110 USD
Zone 2 (Mariposa and Merced)
$101,301-$162,094 USD
OUR BENEFITS
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 PlansAmple Paid Time Off12 Paid Holidays per year401(a) Retirement Plan457 Deferred Compensation PlanRobust Health and Wellness ProgramOnsite EV Charging StationsABOUT US
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.