Stars Quality Specialist - Remote - New York

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For one of our clients, we are looking for a Stars Quality Specialist, working remotely from New York, USA.

As a Stars Quality Specialist, you will play a critical role in improving quality performance and maximizing Star ratings by supporting medication adherence, HEDIS-related functions, and other key quality initiatives. This role requires a keen eye for detail, strong communication skills, and the ability to analyze data to drive decision-making. You will collaborate with internal teams, healthcare providers, and pharmacies to close care gaps, ensure accurate documentation, and contribute to continuous quality improvement efforts. This position is ideal for someone passionate about healthcare quality and patient-centered care.

Accountabilities:

• Support various Star rating measures, including medication adherence, portable device monitoring, and quality improvement initiatives.
• Conduct detailed chart reviews and audits to ensure accurate documentation and identify opportunities for performance improvement.
• Leverage data and reporting tools to prioritize work, track quality metrics, and optimize outcomes.
• Engage in telephonic outreach to members, providers, pharmacies, and internal teams to resolve quality-related issues.
• Work closely with cross-functional teams to address member concerns and ensure a seamless care experience.
• Maintain organized records of completed work efforts and adhere to established processes for documentation.
• Assist in tracking, monitoring, and reporting Stars-related activities while contributing to workflow improvements.

• Understanding of the Medicare Star ratings program and strategies to influence performance.
• Experience in the healthcare industry and/or health insurance sector.
• Proficiency in Microsoft Word, Excel, Outlook, and PowerPoint.
• Ability to work within an electronic health record (EHR) system.
• Bachelor’s degree preferred.
• Completion of an accredited Pharmacy Technician Program is a plus.

• Competitive salary ranging from $20.00 to $25.00 per hour, plus annual bonus opportunities.
• Comprehensive healthcare coverage, including medical, dental, and vision plans.
• 401(k) with company match to support your long-term financial goals.
• Flexible work environment, offering a fully remote position.
• Professional growth opportunities through training and career development.

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