Martin’s Point Health Care – Manager of Medicare Stars Programs

Job Location: Portland, ME

Requisition #: 2015-227

# of openings: 1

Position Summary:

The Manager, Medicare Strategic Programs is responsible for identification, development and implementation of strategic programs with significant focus on Medicare star ratings.  This position works collaboratively with internal teams and external vendors to manage the development and implementation of new programs, approaches and standard reporting capabilities in conjunction with the implementation of new/existing quality measures to allow Martin’s Point to lead the Medicare industry in quality programs.


Key Outcomes:

  • Manages Star Ratings strategy across the organization
    • Provides education, understanding and subject matter expertise regarding the measures and highlights the significant business impacts of improved ratings throughout the organization
    • Collaborates throughout the organization to implement processes/policies that ensure CMS requirements related to current and potential future Medicare Star Rating performance are in place
    • Coordinates activities throughout the organization to drive improvements in provider engagement, clinical care, data integrity, customer satisfaction, communication with members and providers
  • Supports analysis of Star rating elements
    • identifies opportunities for program improvements
    • designing and managing initiatives to support program improvements
    • analyzes financial impacts
  • Understands organizational clinical and operational activities related to Stars measures to ensure alignment and identify opportunities for collaboration
  • Develops and maintains a vision for member engagement and coordinates strategies for member engagement and retention
  • Analyzes metrics, summarizes key business learning, and translates into strategic plans
  • Understands and interprets technical specifications for CAHPS, HOS, and HEDIS measures
  • Manages external vendors for improvement activities

·   Manages external vendors for improvement activities



  • Bachelor’s degree in Health Care or Business Administration required. MHA or MBA preferred
  • At least 5 years experience in health care industry, from payer or provider perspective
  • At least 5 years experience related to reporting and analysis of health care related data with thorough knowledge of SQL, Microsoft Access, and Excel.
  • Experience with financial modeling in a healthcare context preferred


Skills/Knowledge/Competencies (Behaviors):

  • Strong knowledge of Stars/CMS/ Health Care Quality and Provider metrics and incentives
  • Knowledge of managed care operations, Medicare program administration and compliance
  • Ability to apply leadership strength and critical thinking to short-term, mid-range and long-term goals
  • Superior communication skills, both written and verbal, for internal and external audiences
  • Extensive analytical skills and the ability to use data to drive improvement activities
  • Knowledge of data warehousing concepts, applications, and toolsets
  • Expert data manipulation skills using current state tools (SQL, Access)
  • Effective presentation of reporting and analytic results using a variety of tools
  • Knowledge of the health care industry
  • Knowledge of standard health care metrics for payer and provider reporting
Martin’s Point Health Care offers comprehensive employee benefits, including health, dental and life insurance, short and long-term disability, 401K, earned time, 10 holidays per year, and a tuition assistance program.

Martin’s Point Health Care is an Equal Opportunity Employer.