Sr. Manager Medicare Stars Program at CVS Health

St Louis Park, Minnesota, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, MedicareIndustries

Requirements

7–10 years of experience with Medicare Stars programs
Strong analytical and project management skills
Proven ability to influence and motivate teams at all levels
Skilled in problem-solving, decision-making, and collaboration
Growth mindset with agility in developing self and others
Expertise in execution and delivery of strategic initiatives
Comfortable presenting to and influencing senior leadership
Bachelor’s degree preferred or equivalent professional training/qualifications

Responsibilities

Provide strategic direction, analytical oversight, and cross-functional leadership to improve health outcomes and program performance
Collaborate with internal teams (HEDIS, Clinical Operations, Network, Pharmacy, Product, Member Experience, Data/Analytics, Compliance) to implement evidence-based interventions
Partner with external providers and vendors to close quality gaps and enhance value-based performance
Identify performance gaps, prioritize initiatives, track progress, and proactively manage risks to align with CMS methodologies and regulatory updates
Serve as a strategic thinker and hands-on leader with deep knowledge of CMS Stars (HEDIS, Operations, Patient Safety, CAHPS, HOS)
Collect and analyze data, draw actionable insights, and develop improvement strategies
Lead the market-wide strategy, performance improvement, and execution of the Medicare Stars quality program for Allina Health | Aetna Medicare membership in Minnesota to achieve and sustain high Star Ratings across all eligible contracts by driving measurable improvements in clinical quality, member experience, medication adherence, and operational performance

Skills

Medicare Stars

HEDIS

CAHPS

HOS

CMS methodologies

analytical skills

project management

data analysis

quality improvement

clinical quality

medication adherence

value-based performance

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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