Becky Simmons

Stars Program Manager @Security Health Plan

Drove overall Medicare Stars rating from 4.0 to 4.5 Stars for MY2024, achieving significant improvement in over 50% of all measures, including 45% of CAHPS measures (with one-third of measures gaining two full Stars). Delivered 5-Star Health Plan Quality Improvement and 4-Star Drug Plan Quality Improvement, securing the maximum 40-point Reward Factor and strengthening financial performance for MY24. Advanced Drug Plan performance by improving medication adherence for statins and Statin Use in Persons with Diabetes (SUPD), contributing to higher Part D performance. Partner with cross-functional teams to elevate provider engagement, enhance member experience, and close care gaps across HEDIS, CAHPS, and HOS measures. Translate complex CMS regulations into actionable strategies, ensuring compliance and driving continuous improvement initiatives. Develop and present data-driven performance reports to executive leadership, informing strategic planning and resource allocation. Manage the Chronic Care Improvement Project (CCIP), resulting in a full Star increase in Osteoporosis Management for Women with a History of Fractures (OMW) and improved care coordination for high-risk populations. Lead provider engagement initiatives with network providers to support Value-Based Care and Pay-for-Performance agreements, aligning incentives with quality outcomes and closing care gaps.