New
STARS Quality Specialist
Mass General Brigham Health Plan | |
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399 Revolution Drive (Show on map) | |
Apr 21, 2026 | |
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Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. The Quality STARS Specialist supports a clinical health plan's CMS Star Ratings performance by monitoring quality measures and translating data into actionable insights that improve care delivery, member experience, and outcomes. Partners with clinical, quality, pharmacy, provider, and operational teams to identify performance gaps, support outreach and care gap closure initiatives, and track progress across HEDIS, CAHPS, HOS, and related measures. Serving as a subject matter expert in Star Ratings methodology and analytics, supports regulatory compliance, audit readiness, program coordination, and process improvement to strengthen quality performance and operational effectiveness. Principal Duties and Responsibilities: Data Monitoring and Reporting oTrack performance on CMS Star Ratings measures across HEDIS, CAHPS, HOS, pharmacy, and operational metrics. oPrepare routine and ad hoc reports for leadership, quality teams, and operational partners. oIdentify performance gaps using data analysis and recommend targeted interventions. oMaintain dashboards, scorecards, and measure level documentation. oA subject matter expert for the STARS analytics tool Quality Improvement Support oAssist in developing and executing quality improvement initiatives to raise Star Ratings. oSupport provider and member outreach campaigns aimed at closing care gaps. oCoordinate with clinical teams to ensure timely completion of preventive screenings, chronic condition management, and medication adherence activities. oMonitor progress of interventions and escalate issues when performance lags. Cross-Functional Collaboration oWork closely with departments such as Quality, Clinical Operations, Member Experience, Provider Relations, Pharmacy, and IT. oSupport provider engagement efforts, including distributing measure education, performance summaries, and best practices. oParticipate in internal workgroups focused on improving specific STARS measures. Regulatory & Compliance Support oStay current on CMS Star Ratings methodology, technical specifications, and regulatory updates. oEnsure internal processes align with CMS requirements and audit expectations. oAssist with documentation for audits, mock audits, and compliance reviews. Program Coordination & Administration oManage timelines, deliverables, and project tracking for STARS initiatives. oSupport vendor coordination, including data exchange, reporting, and performance monitoring. oMaintain organized records of program activities, interventions, and outcomes. oAssist with annual planning for STARS strategy and operational execution. oHelp design and execute outreach campaigns to improve member experience and close gaps in care. oSupport provider education on measure requirements, coding accuracy, and documentation standards. oCoordinate distribution of materials, toolkits, and communications. Process Improvement oIdentify workflow inefficiencies and recommend enhancements to improve measure performance. oSupport implementation of new tools, processes, or technologies that streamline STARS operations. oDocument standard operating procedures (SOPs) and maintain process guides. oBreaks complex topics into meaningful chunks of information. oSeeks out multiple sources to gather information. Education
Experience
Knowledge, Skills, and Abilities
Working Conditions
Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. | |
Apr 21, 2026