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Medicare Advantage Quality Consultant

Highmark Health
Location 📍 United States, United States
Posted 📅 June 14, 2026
Work Type ⏰ Full time

Position Overview

Description

JOB SUMMARY

This job is directly responsible for the value creation, impact and cost control and fiscal/ROI targets as set by the Organization, including revenue stream outcomes, and engagement of primary care providers (PCP) enrolled in government value-based reimbursement programs and continuous improvement models.This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value creation, cost control and utilization, performance, and develops strategic plans in collaboration with PCPs and the inter-departmental teams for transformation of workflows resulting in outstandingperformance in government program(s) ensuring that ROI targets set by the Organization are met or exceeded.Further, in...

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Job Details

Employment Type
Full time
📊
Category
Business Operations Specialists
🏠
Work Arrangement
On-site
📍
Location
United States, United States