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Healthcare, Hospitals

Quality Specialist 2 - Member Experience & Medicare Performance - St. Luke's Health Plan

Boise, IDHybridFull TimePosted 17 days agoVisa sponsorship available

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Required skills

  • Medicare Stars
  • CAHPS
  • HOS
  • member feedback
  • complaints
  • grievances
  • quality data
  • customer service
  • provider engagement
  • operational teams

Role summary

St. Luke's Health Plan is seeking a Quality Specialist to enhance member experience and Medicare performance. This role involves analyzing data, collaborating with various teams, and executing operational strategies to improve Medicare Stars, Health Plan Ratings, and member satisfaction. The specialist will also shape member communications and ensure compliance with regulatory requirements, acting as a key partner in quality improvement initiatives.

Description & Requirements

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work.

As a Member Experience & Medicare Performance Quality Specialist, you’ll play a key role in improving the experiences and outcomes that matter most to our members. This is an exciting opportunity to leverage data, collaboration, and innovation to drive performance across Medicare Stars, Health Plan Ratings, and other key member experience measures.

What You Can Expect

This Quality Specialist supports quality improvement, regulatory, and member experience initiatives through data analysis, stakeholder collaboration, and operational execution.

In this role, you will have the opportunity to:

  • Drive CAHPS, HOS, Medicare Stars, and member experience performance by transforming member feedback, complaints, grievances, and quality data into meaningful improvement strategies.
  • Collaborate with customer service, provider engagement, operational teams, and vendors to enhance service recovery, improve access to care, and elevate member satisfaction.
  • Shape member communications, outreach, education, and incentive programs that strengthen engagement and improve quality outcomes.
  • Influence organizational performance by monitoring action plans, analyzing results, and identifying opportunities to improve member experience measures and Health Plan Ratings.
  • Serve as a trusted quality partner, helping the organization stay ahead of regulatory requirements, industry trends, and evolving member experience priorities.

Requirements

  • Education: Bachelor’s degree or equivalent combination of education and experience in lieu of degree
  • Experience: Two (2) years’ relevant experience

What's In It For You

At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.

St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.

*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.

General Information

Department Leased Shared Services Position Type Full-Time Shift Day Job ID 158184 City Boise State ID Category Admin/Clerical/Customer Support, Professional, Quality, Risk & Patient Safety Remote Hybrid
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