Medicare Advantage Stars Program Manager, Peformance Measurement & Improvement (Hybrid/Troy, MI) - Health Alliance Plan
Role summary
The Program Manager will lead governance and execution oversight for Medicare Star Rating Program (Stars) initiatives. This role partners with Healthcare Management leadership to translate strategic goals into actionable programs, ensuring visibility, accountability, and performance tracking. Responsibilities include developing a governance framework, maintaining monitoring systems with dashboards and reporting, acting as a liaison between leadership and operational/vendor teams, and managing program timing, quality, and financial results. The role requires strong cross-functional stakeholder management, risk management, and budget oversight, with a focus on driving transparency and accountability across the organization. A Bachelor's degree and 5 years of experience in healthcare delivery and project management are required.
General Summary
Under minimal supervision, the Program Manager will lead governance and execution oversight for Medicare Star Rating Program (Stars) initiatives across the organization. This role will partner closely with Healthcare Management divisional leadership to translate strategic goals and priorities into actionable programs, ensuring visibility, accountability, and performance tracking. The program manager will support cross-functional teams in delivering prioritized Stars initiatives efficiently and effectively, using structured governance, centralized dashboards, and continuous monitoring to drive transparency and accountability.
Duties And Responsibilities
- Serve as the operational counterpart to the Stars Leadership team, translating strategic goals and priorities into actionable, trackable initiatives.
- Lead the development and execution of a governance oversight framework to monitor, prioritize, and align Medicare Stars initiatives across multiple departments within the organization.
- Maintain a continuous monitoring system that includes program metrics, milestone charts, roadmap, schedule, project plan, executive dashboards, tracking tools, and real-time reporting on program health and progress against goals.
- Act as a liaison between Stars leadership, operational teams, and vendor teams, as applicable ensuring consistent communication of goals, progress, and risks for program measures and categories including HEDIS/HOS, CAHPS, Pharmacy, and Plan Operations/Member Experience.
- Establish clear roles, responsibilities, and escalation paths to streamline decision-making and ensure accountability among internal teams, operational stakeholders, and executive sponsors.
- Develop program and project-level success KPIs, ensuring value is being realized, and leverage reporting mechanisms to monitor performance.
- Manage timing, quality, and financial results of Medicare Stars programs/projects from start to finish, to meet customer needs and ensure winning performance.
- Primary point of communication with strong cross-functional stakeholder management skills for business and IT partners for the assigned program; maintaining strong partnerships and ensuring timely and accurate communication of Medicare Stars program updates to key stakeholders and HAP leadership.
- Leverages program documentation and action-oriented behavior to navigate ambiguity and seek clarity as priorities change.
- Manage risks and issues within the program and escalate unresolved issues to senior leadership as required.
- Promote individual professional growth and development; serve as a mentor and resource to less experienced project managers.
- Leverage creative, "out-of-the-box" thinking to develop original solutions to overcome roadblocks and meet or exceed project requirements and expectations.
- Manage post implementation support and provide post implementation project review.
- Support procurement processing of RFPs, Vendor Contracting, Purchase Orders, and other contract-related artifacts.
- Act as a subject matter expert providing project management methodology consulting to project-level team members.
- Manage the Stars Oversight program budget, including evaluating proposals, managing executive approval, coordinating cross-functional reviews of value achieved, and ongoing monitoring of financial reports, invoices, trends, and forecasts.
- Other duties as assigned.
Education/Experience Required
- Bachelor’s degree in Business Administration, Project Management, Healthcare Administration, or related field.
- Master’s degree preferred.
- At least five (5) years of experience in healthcare delivery, project management, and running large projects of a complex nature.
- Two (2) years of experience using data to drive business decisions, preferred.
- Two (2) years of managed care/insurance related business, preferred.
- Experience with the Medicare Star Rating Program, HEDIS, or Quality preferred.
- Effective oral and written communication and interpersonal skills.
- Strong presentation skills.
- Must be able to work autonomously with strong task management skills.
Additional Information
- Organization: HAP (Health Alliance Plan)
- Department: Performance Measurmt&Imprvmt
- Shift: Day Job
- Union Code: Not Applicable