Lead diagnostics development and commercialization for GSK's Oncology portfolio. Manage cross - functional teams to deliver innovative diagnostics while ensuring compliance with regulations.
About the role
- 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
- Paid life insurance for employees
- Pet care insurance
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