Stars Program Specialist (Bilingual Chinese or Vietnamese)

Star Programs Specialist Job Summary The Star Programs Specialist is responsible for assisting with the deployment and implementation of member experience improvement strategies, collecting and tracking member feedback from all channels in the organization. The specialist works closely with the Network / Provider Relations Team for continuous training and education on CAHPS measures under the CMS Star Programs and with the Customer Service Team to resolve member‑related incidents. Functions & Job Responsibilities Engage providers through focused, meaningful educational approaches to proactively address member abrasion points. Drive providers to take an active role with the Clever Care Health Plan’s quality improvement programs and various health‑centered incentives. Support process improvement in collaboration with management efforts. Collaborate with the Customer Service Team and work to resolve escalated member incidents pertaining to access to care, vendor, Rx and other issues. Facilitate fax or telephone call notification for providers targeted at Star measures. Create PowerPoint decks and other training materials for providers and staff. Monitor and ensure that key Star/CAHPS activities are completed on time and accurately to present results to key departmental management and other departments as needed. Collect and compile the required documentation to maintain critical quality improvement functions. Participate in Star activities, meetings, and discussions with internal and external partners (PCPs, IPAs, MSOs). Assist in evaluating project/program activities and results to identify opportunities for improvement. Surface gaps in processes to the Director that may require remediation. Other duties as assigned. Qualifications Education: Bachelor’s Degree or equivalent combination of education and work experience. Minimum three (3) years’ experience in healthcare. Minimum two (2) years’ experience in health‑plan quality improvement, managed care or equivalent. Knowledge of CMS Star Programs, HEDIS, CAHPS. Valid driver’s license with reliable transportation and a clean driving record. Skills Team player, leader, and individual contributor who can engage parties cross‑functionally and facilitate operational change. Proven track record of implementing provider outreach and educational programs; able to analyze performance and identify improvement opportunities. Solid business writing experience and strong communication, writing, proofreading, and grammar skills. Prior experience with project coordination and timelines. Excellent organizational skills and attention to detail. Proficiency with MS Word, Excel, and PowerPoint. Ability to interact with all levels of the organization and external stakeholders. Superior meeting facilitation skills and knowledge of HEDIS technical requirements. Understanding of CMS 5‑Star program requirements. Other Willingness to travel locally to provider offices. Minimum salary: $72,800 to $80,000 per year (California wages; may vary by state residency). Physical & Working Environment Must be able to travel when needed or required. Operate a keyboard, mouse, phone, and perform repetitive motions; write (note‑taking). Ability to sit for long periods; stand, sit, reach, bend, and lift up to fifteen (15) lbs. Express or exchange ideas to convey detailed instructions to staff accurately and quickly. Work performed in an office environment and/or remotely; may require irregular hours based on business needs. Clever Care Health Plan is a proud Equal Employment Opportunity and affirmative action workplace. Individuals seeking employment will receive consideration without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, marital status, disability, protected veteran status or any other status protected by law. A background check is required. #J-18808-Ljbffr Paycom