Medicare Star Ratings Nurse Senior Manager

Job DescriptionWork at home with strong preference to reside in Market (GA, LA, MS, AL).Standard business hours Monday-Friday.Approximately 10-15% of expected travel to meet provider groups in person.This role is responsible for leading Medicare Advantage Star Ratings initiatives for the Georgia & the Gulf States Medicare Market ( GA, LA, MS, AL). This role works directly with provider groups and their staff to close clinical and pharmacy quality measure gaps. This position will meet regularly with internal and external leaders and stakeholder to review provider performance and formulate tactics to facilitate continuous improvement. This role also works directly with members to schedule provider visits to address gap closure and supports development/execution of local market initiatives to improve Star Ratings. Accountable for designing conceptual models, contracting, initiative planning, business results and ongoing client relationship management and satisfaction for smaller to moderate scale and complexity high value initiatives and parts of larger initiatives that impact the delivery of products and services to the internal and external environment (See Family Summary). Responsible for providing guidance and direction to external vendors, external consultants, consulting team members and/or matrixed staff as required in support of initiatives. Accountable for transferring knowledge, best practices (external and internal), methodology and tools to client organizations. May be responsible for concurrent initiatives as team lead and/or team member, based on resource requirements.Pay RangeThe typical pay range for this role is:Minimum: 75,400Maximum: 158,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications- Active and good standing RN for state of residence - 5+ years experience with Medicare Star Ratings and HEDIS- 7+ years experience working with physicians, hospitals, or health plans - 3+ years of experience using Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web based meetings.Preferred Qualifications- Additional experience with PQA, CAHPS and HOS.- Management consulting, project consulting, business process consulting, strategic business planning, - Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.-Demonstrated leadership with relevant initiatives: Business process, enterprise business project management/consulting, financial strategic planning and analysis, mergers and acquisitions, strategic planning, risk management. -Demonstrated superior business process, project management and organizational redesign experience. -Demonstrated experience successfully implementing change in complex organizations. -Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity.EducationBSN minimum required. Masters degree preferred, but not requiredBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-15