About the role

Program Director leading Medicare Star Ratings quality improvement program at Cambia. Managing teams, strategic goals, and complex projects in a multi-state environment.

Responsibilities

Provides leadership in developing, implementing, and communicating short and long-range strategic plans, goals, and objectives for Government Program and Stars teams.
Aligns team strategy and goals with the organization’s vision and strategy.
Leads tactical execution of a large scale, complex Star Ratings quality improvement program in a multi-state environment.
Works closely with cross-functional leaders to clarify program goals and create operational plans to continuously improve our Star Ratings.
Provides day-to-day leadership of direct reports, cross-functional committees, and vendors.
Works collaboratively with teams to plan, design, develop, implement, and manage projects.
Serves as a subject matter expert on trends, gaps, best practices, competitive intelligence, and effectiveness regarding Star Ratings.
Represents program goals and initiatives with various audiences.
Cultivates and maintains relationships with key internal and external stakeholders.
Develops and oversees monitoring and reporting procedures to ensure deliverables and budget are on track.
Communicates program status and areas of risk or opportunity.
Handles all management level responsibilities for direct staff, including performance reviews, employee development, hiring, coaching, counseling, and retention.
Partners with cross-functional leaders, provider groups, and vendors to lead organizational change.
Creates a sense of urgency within the organization and translates quickly evolving directions into action.

Bachelor’s degree in Business Administration, Healthcare Administration, or related field (Master’s degree preferred)
10 years of experience in Medicare operations and business process improvement
5 years of management/leadership experience or equivalent combination of education and experience
Expertise regarding Medicare programs with a focus on Medicare Advantage and Part D programs.
Proven ability to lead the design, development and implementation of process structure, tools and measurement indicators that drive operational results.
Demonstrated ability to think analytically, apply analytical techniques, and provide in-depth analysis and recommendations using critical thinking and sound judgment.
Experience with business process redesign and optimization including ability to recognize process deficiencies and recommend and implement improvements.
Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
Demonstrated ability to lead high performing teams and to organize and support cross functional activities to deliver results in a matrix organizational structure.
Ability to synthesize customer and third-party feedback into operational solutions that drive ongoing enhancements to member experience within the government programs arena.
Excellent written and verbal communication skills, ability to present and facilitate and drive executive level discussions and strong customer and stakeholder management skills.

Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
Annual employer contribution to a health savings account.
Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
Award-winning wellness programs that reward you for participation.
Employee Assistance Fund for those in need.
Commute and parking benefits.