Medicare STARS Director
IMH
full-time
Posted on:
Location Type: Hybrid
Location: Murray • Colorado • Idaho • United States
Visit company websiteExplore more
Salary
💰 $78 - $120 per hour
Job Level
About the role
- Provides strategic and operational leadership for the organization’s Medicare Advantage Star Ratings program.
- Accountable for the development, execution, and continuous improvement of initiatives that drive performance across all CMS Star measures.
- Partners across clinical, operational, analytic, and compliance functions to ensure alignment with CMS requirements, sustained quality improvement, and achievement of targeted Star Ratings performance.
- Translates regulatory requirements and performance analytics into actionable strategies.
- Drives cross-functional accountability and ensures operational readiness for all Star-related submissions, audits, and validations.
- Develops and implements a multi-year Medicare STARS strategy aligned with organizational goals and financial performance.
- Leads the STARS workplan, including prioritization of measures, intervention design, timelines, and performance targets.
- Establishes and leads STARS governance structures, including executive steering committees and cross-functional workgroups.
- Monitors and manages to CMS regulatory guidance, Technical Notes, and cut-point trends.
Requirements
- Ten (10) or more years of progressive experience in Medicare Advantage, managed care, or highly regulated healthcare environments.
- Seven (7) or more years of direct leadership responsibility for Medicare STARS, quality improvement, HEDIS, CAHPS, Part D, or enterprise performance management.
- Demonstrated success leading Star Ratings improvement or recovery efforts in complex or underperforming environments.
- Proven track record of improving or sustaining 4-Star or higher performance, or leading material performance recovery efforts.
- Experience managing enterprise vendor portfolios, including HEDIS, CAHPS, pharmacy analytics, MTM, and member experience platforms, with clear performance accountability.
- Direct experience supporting CMS audits, data validations, corrective action plans, and regulatory inquiries related to Star Ratings.
- Experience influencing senior executives, Boards, providers, and cross-functional leaders to achieve measurable performance outcomes.
- Strong analytical orientation with experience leveraging data to inform strategy, investment decisions, and operational execution.
- Exceptional executive communication, presentation, and stakeholder-management skills.
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
- Sign-on bonus
- Relocation bonus
- Annual Pay for Performance Plan
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medicare AdvantageStar Ratingsquality improvementHEDISCAHPSPart Denterprise performance managementdata validationregulatory complianceperformance analytics
Soft Skills
strategic leadershipoperational leadershipcross-functional collaborationanalytical orientationexecutive communicationpresentation skillsstakeholder managementinfluencing skillsperformance accountabilityintervention design