Lead strategy and performance of Medicare Stars quality program for CVS Health, focusing on high star ratings and improving health outcomes. Collaborate across functions and guide external partnerships in execution.
Responsibilities
Provide strategic direction , analytical oversight, and cross-functional leadership to improve health outcomes and program performance.
Collaborate with internal teams (HEDIS, Clinical Operations, Network, Pharmacy, Product, Member Experience, Data/Analytics, Compliance) to implement evidence-based interventions.
Partner with external providers and vendors to close quality gaps and enhance value-based performance.
Identify performance gaps, prioritize initiatives, track progress, and proactively manage risks to align with CMS methodologies and regulatory updates.
Serve as a strategic thinker and hands-on leader with deep knowledge of CMS Stars (HEDIS, Operations, Patient Safety, CAHPS, HOS).
Collect and analyze data, draw actionable insights, and develop improvement strategies.
Requirements
7–10 years of experience with Medicare Stars programs.
Strong analytical and project management skills.
Proven ability to influence and motivate teams at all levels.
Skilled in problem-solving, decision-making, and collaboration.
Growth mindset with agility in developing self and others.
Expertise in execution and delivery of strategic initiatives.
Comfortable presenting to and influencing senior leadership.
Health plan experience.
Familiarity with CMS measurement methodologies and regulatory updates.
Bachelor’s degree preferred or equivalent professional training/qualifications.
Benefits
Affordable medical plan options
a 401(k) plan (including matching company contributions)
an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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