Director of Medicare Stars overseeing and improving CMS Star Ratings program for IEHP. Leading cross-functional initiatives to enhance quality outcomes and member experience.
Responsibilities
Reporting to the Chief Quality Officer, the Director of Medicare Stars is responsible for leading the strategic direction, execution, regulatory compliance, and continuous performance improvement of the Medicare Star Ratings program at IEHP.
This role will oversee enterprise-wide cross-functional initiatives to drive quality outcomes, enhance member experience, and ensure compliance with the Center of Medicare & Medicaid Services (CMS) Star Ratings requirements.
The Director develops and implements data-driven strategies that improve performance across all Star measures in collaboration with clinical, operational, IT, and analytics team.
By providing strategic oversight, fostering cross-functional collaboration, and leveraging data-driven insights, the Director will ensure IEHP not only meets, but exceeds CMS expectations enhancing quality outcomes, member experience, plan reputation, financial incentives, and driving sustainable growth.
Requirements
Seven (7) years of progressive experience in Medicare Advantage, quality improvement in a health plan setting or health plan operations.
Three (3) years of leadership experience managing teams or large-scale cross-functional initiatives.
Proven track record of driving performance improvement and achieving quality benchmarks
Proven track record of improving Star Ratings performance preferred.
Experience working with NCQA, CMS audits, or Medicare Advantage plan operations preferred
Bachelor’s degree in Health Administration, Public Health, Business Administration, or a related field from an accredited institution required
Master’s Degree (MPH, MHA, MBA, or related) from an accredited institution preferred
Valid California Driver’s License preferred
Expert comprehensive knowledge of CMS Star Ratings, HEDIS, CAHPS, HOS, and related quality measures for health plans
Excellent communication, presentation, executive presence, interpersonal, and relationship building skills.
Excellent analytical, critical thinking, problem-solving skills and experience with data tools (e.g., Power BI, Tableau, SAS, SQL)
Collaborative leader with ability to drive influence across the organization.
Strategic thinker with strong business acumen.
Data-driven and outcomes-focused
Benefits
Competitive salary
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Life, short-term, and long-term disability options
Career advancement opportunities and professional development
Wellness programs that promote a healthy work-life balance
Flexible Spending Account – Health Care/Childcare
CalPERS retirement 457(b) option with a contribution match
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