Medicare Stars Rating Spec. (El Paso Health)

Position Overview

Responsible for the development, implementation, and oversight of quality initiatives that impact Medicare Star Ratings within the El Paso Health organization. Strategically monitors, analyzes, and drives improvement in Star Ratings programs to ensure they align with overall strategic organizational goals and performance standards. Provides data and analytical support to advance the Star Ratings initiatives and analyzes provider performance metrics to identify opportunities for improvement.

Location: University Medical Center of El Paso · EPH Quality Improvement_2
Schedule: Full Time, Days, M-F 8-5

Required Qualifications

• Knowledge of CMS, TDI, HHSC, NCQA, and URAC rules and standards to assure compliance.
• Proficient in analytical assessment and creative problem solving.
• Strong project management skills with the ability to meet deadlines while producing quality analyses.
• Highly organized and detail-oriented.
• Ability to work with complex Excel functions, pivot tables, data modeling, and dashboard creation for healthcare analytics.
• Ability to create clear, actionable visualizations that effectively communicate complex healthcare data.
• Knowledge of health plan systems and organizational relationships.
• Understands and utilizes the fundamentals of continuous quality and process improvement.
• Excellent verbal and written communication skills.
• Self-starter with the ability to work independently and take initiative.
• Ability to maintain awareness of changing healthcare industry trends and applications.
• Two years of experience analyzing healthcare data and claims to identify quality improvement activities.
• Bachelor degree in Business Administration, Healthcare Administration, Public Health or a related field is required.

Preferred Qualifications

• Experience carrying out quality improvement initiatives from study and design through implementation.
• Experience in an HMO or managed care setting with Medicare and Star Ratings knowledge.
• Certified Professional in Healthcare Quality (CPHQ) is preferred.