Medicare Advantage Quality Consultant - Central, PA
Highmark Health(1 month ago)
About this role
A Medicare Advantage Quality Consultant at Highmark is a subject matter expert in government value-based reimbursement programs, including Medicare STARS, Medicaid HEDIS, and risk revenue. The role focuses on driving value creation and meeting ROI targets through data-driven analysis, collaboration with primary care providers, and cross-functional coordination. It supports transformation of PCP workflows and optimizes performance in government healthcare programs.
Required Skills
- Data Analysis
- Strategic Planning
- Provider Engagement
- Chart Reviews
- Population Health
- Presentation Skills
- Communication
- Continuous Improvement
- Project Management
- Stakeholder Management
+3 more
Qualifications
- Bachelor's Degree in Clinical or Healthcare Field
- Master's Degree in Clinical or Healthcare Field (Preferred)
About Highmark Health
highmarkhealth.orgA national health and wellness organization as well as the second largest integrated delivery and financing system in America.
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