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Medicare Stars Program Manager Jobs (NOW HIRING)

Spectrum Health

Director STARS

Grand Rapids, MI

Leads Medicare Stars Team including analytics, program management and outreach activities; directs overall Stars improvement strategy, including identifying strategic focus areas, planning ...

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Apex Informatics

Program Manager

Program Manager (75432) Duration : 9+ Months Location : Oakland, CA ( Remote - one day in a month ... Knowledge in Value-based payment models, HEDIS, or Medicare Stars * Clinical workflow Optimization ...

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How much do medicare stars program manager jobs pay per year?

As of Jun 6, 2026, the average yearly pay for medicare stars program manager in the United States is $89,734.00, according to ZipRecruiter salary data. Most workers in this role earn between $71,000.00 and $98,500.00 per year, depending on experience, location, and employer.

What are some common challenges faced by a Medicare Stars Program Manager, and how can they be addressed?

A Medicare Stars Program Manager often encounters challenges such as coordinating cross-functional teams, interpreting complex CMS regulations, and maintaining high performance across all Star Rating measures. Success in this role requires strong project management skills, effective communication with clinical and operational departments, and a proactive approach to identifying performance gaps. Building robust data tracking systems and fostering a culture of continuous quality improvement can help address these challenges and drive better outcomes for the organization.

What is the difference between Medicare Stars Program Manager vs Medicare Data Analyst?

AspectMedicare Stars Program ManagerMedicare Data Analyst
Required CredentialsBachelor's degree, experience in healthcare or insurance, knowledge of CMS guidelinesBachelor's degree in data analysis, statistics, or related field; proficiency in data tools
Work EnvironmentHealthcare organizations, insurance companies, government agenciesData-focused roles within healthcare or insurance sectors
Employer & Industry UsageUsed to oversee quality ratings and performance metricsUsed to analyze Medicare data for reporting and insights

The Medicare Stars Program Manager focuses on managing quality improvement initiatives and performance ratings within Medicare, requiring project management and healthcare knowledge. In contrast, the Medicare Data Analyst primarily analyzes Medicare data to support decision-making. Both roles require healthcare industry familiarity but differ in their focus—program management versus data analysis.

What are the key skills and qualifications needed to thrive as a Medicare Stars Program Manager, and why are they important?

To thrive as a Medicare Stars Program Manager, you need expertise in healthcare quality improvement, data analysis, regulatory compliance, and a relevant degree in healthcare administration or a related field. Familiarity with CMS Star Ratings, HEDIS, CAHPS, and proficiency in data reporting tools like SAS or SQL are typically required. Strong project management, leadership, and cross-functional communication skills help drive performance improvements and stakeholder engagement. These skills ensure successful navigation of complex CMS requirements, ultimately enhancing plan ratings and patient outcomes.

What is a Medicare Stars Program Manager?

A Medicare Stars Program Manager is a professional responsible for overseeing and improving a healthcare organization's performance on the Centers for Medicare & Medicaid Services (CMS) Star Rating system. This role involves analyzing quality measures, coordinating initiatives to enhance patient care, and ensuring compliance with CMS regulations. The Program Manager works closely with clinical teams, data analysts, and leadership to develop strategies that improve patient outcomes and increase the organization's Star Rating, which can impact reimbursement and reputation. Their work is crucial in helping Medicare Advantage plans achieve high performance and maintain competitiveness in the healthcare market.
What cities are hiring for Medicare Stars Program Manager jobs? Cities with the most Medicare Stars Program Manager job openings:
What states have the most Medicare Stars Program Manager jobs? States with the most job openings for Medicare Stars Program Manager jobs include:
What job categories do people searching Medicare Stars Program Manager jobs look for? The top searched job categories for Medicare Stars Program Manager jobs are:
Medicare Stars Program Manager jobs near you
Infographic showing various Medicare Stars Program Manager job openings in the United States as of May 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $89,734 per year, or $43.1 per hour.
Quality Stars Program Coordinator

Quality Stars Program Coordinator

The Health Plan of West Virginia Inc

Wheeling, WV • On-site

Full-time

Posted 4 days ago

Job description

Under the leadership and direction of the Vice President Quality Improvement, the Quality Stars Program Coordinator will focus on the clinical operations for Medicare Star initiatives and other quality improvement initiatives that interface with Clinical Services, Pharmacy, Quality Improvement and the Medical Economics Departments. This position is responsible for data analysis and reporting to identify trends, gaps in care, and opportunities for improvement. Conducts outreach to members and providers to improve adherence to measures. Reviews and analyzing member and provider complaints along with survey results to improve outcomes. Interfaces with the Provider Operations and Provider Experience teams for quality provider initiatives and provider education. See job description attached.

Required:

  1. Bachelor's degree or equivalent healthcare industry experience (five years).
  2. Minimum of two years of experience related to any of the following: Managed Care, Medicare Stars, HEDIS, CAHPS, HOS.
  3. Has the ability to prioritize and pivot to achieve goals with minimal supervision.
  4. Ability to build working relationships with internal staff and external stakeholders including community and vendor partners.

Desired:

  1. Medicare Star Ratings experience with the ability to analyze and interpret cut point predictions.

Responsibilities:

  1. Works with VP, Quality Improvement and Clinical Quality Stars Program Manager to learn and apply the Medicare Part C&D Star Ratings Technical Notes.
  2. Communicates with the Medical Economics Department and the Clinical Quality Stars Program Manager to obtain ongoing HEDIS and Stars data collections to support SMART goals.
  3. Works with internal departments to identify opportunites for improvement, gap closure and facilitates the development of member and provider clinical data driven initiatives to promote optimal member outcomes and provider best practices.
  4. Assists with tracking systems for reporting KPIs for the evaluation of activities and the effectiveness related to program initiatives and other performance/quality improvement projects.
  5. Interfaces with the Provider Operations and Provider Experience teams for quality provider initaitives and provider education.
  6. Using the PDSA cycle, identifies barriers and opportunities for improvement related to Star ratings, NCQA, CAHPS and HOS surveys and other member experience or quality metrics.
  7. Assists to development training and educational material that directly impacts quality initiatives.
  8. Participates in quality improvement meetings and committees/subcommittees and focus groups.

Equal Opportunity Employer

The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.


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