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About the role
The Measure Optimization Lead - CC addresses complex business challenges affecting HEDIS Care Coordination measure performance. The role uses established reporting, operational knowledge, and input from internal and external partners to provide insights and recommendations to decision-makers. The Measure Optimization Lead works across initiatives of diverse scope and complexity, ranging from moderate to substantial.
What they're looking for
- Lead the HEDIS Care Coordination measure optimization strategy and identify opportunities to improve performance
- Evaluate business and operational factors affecting measure outcomes and recommend targeted improvements
- Translate measure requirements, performance insights, and business needs into clear priorities and implementation plans
- Prepare high-quality materials and recommendations for vice presidents and senior leadership discussions
- Participate in strategic conversations, providing actionable insights and clear recommendations
- Communicate complex HEDIS, operational, and performance concepts in a clear and compelling manner to non-technical audiences
More about this role
The Measure Optimization Lead - CC addresses complex business challenges affecting HEDIS Care Coordination measure performance. The role uses established reporting, operational knowledge, and input from internal and external partners to provide insights and recommendations to decision-makers. The Measure Optimization Lead works across initiatives of diverse scope and complexity, ranging from moderate to substantial.
The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations. In this pivotal role, you will provide HEDIS subject matter expertise and strategic leadership to advance Care Coordination measure performance. You will identify improvement opportunities, guide cross-functional initiatives, and translate approved reporting and analysis into clear recommendations for leadership. Your work will directly support decision-making and Stars improvement efforts that improve member care, strengthen plan quality, and advance organizational goals.
- Lead the HEDIS Care Coordination measure...
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