Director, Medicare Stars

The Director, Medicare Stars provides organization-wide leadership and performance oversight for Medicare Star Ratings. This position is responsible for developing the annual and multi-year strategy to drive high quality Medicare Stars ratings across Medica. Success in this position requires in depth Medicare Stars expertise, Stars data and analytics framework, and strong collaborative matrix-leadership with business owners across the organization to drive year over year improvement in Stars measures, embed a quality and Stars mindset into daily operations and advance Health Equity.

Key Accountabilities:

• Medicare Stars Strategy
  
  
  
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    Develops and manages annual and multi-year Stars strategy to drive Stars performance

    
    
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    Remains abreast of CMS planned Medicare Stars Program changes and industry best-practices ensuring appropriate incorporation in Stars strategies and initiatives

    
    
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    Ensures all levels of organization understand Stars strategy, critical priorities and team/individual role in driving Stars success

    
    
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    Partners with cross-functional leaders to identify and elevate organizational priorities that drive Stars performance, highlighting alignment with other organizational priorities and transformational work

    
    
  
  
  
  
• Medicare Stars Program Infrastructure & Performance Oversight
  
  
  
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    Promotes Medica-wide understanding, communication and coordination of the Medicare Stars Quality Program, Medicare Stars Strategy and business areas roles in driving success

    
    
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    Designs and facilitates cross-organizational governance structure to ensure transparency and engagement in Stars performance

    
    
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    Directs ongoing optimization of Stars performance management tools including performance dashboards, stars forecasting tools, financial impact assessment, measure-specific leading indicators and key business operational metrics diving Stars

    
    
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    Prepares materials and updates for VPs and Executive Leadership to understand Stars strategy and priority, Stars performance, escalations and support needs

    
    
  
  
  
  
• Stars team management & development
  
  
  
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    Designs and continually evaluates Stars program team structure to ensure optimal organizational support in driving Stars success

    
    
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    Directly manages Stars Program team in identifying, prioritizing, developing, implementing and evaluating Stars initiatives in alignment with Stars Strategy

    
    
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    Develops team members in growing Stars expertise, collaborative, matrix leadership skills and attaining career development goals

    
    
  
  
  
  

Qualifications:

• Bachelor's degree or equivalent years of work experience
• 10+ years of progressive experience in Medicare Stars, Quality Improvement or Medicare product
• 5-8 years of leadership experience preferred

Skills and Abilities:

• Extensive experience in health plan quality, CMS Stars and HEDIS operations and strategy
• Experience with multiple plan types (D-SNP, Medicare Advantage, etc)
• Expertise in healthcare data practices and integrating data-driven insights into actionable strategies
• Proven ability to lead high-impact strategic initiatives, driving significant improvements in quality performance and organizational alignment
• Strong understanding of industry trends, regulatory requirements, and the evolving landscape of healthcare quality metrics
• Proven problem solving skills; ability to collect and analyze data, draw relevant conclusions, and devise appropriate courses of action

This position is a Remote role and will work remotely 100% of the time. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.

The full salary range for this position is $111,200 - $190,600. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.