Director Medicare Stars Strategy

Who We Are Point
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Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point
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Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point
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Health .

Job Summary The Director, Medical Stars Strategy is a strategic, action-oriented leader responsible for the overall Medicare Stars strategy, planning, execution, and management of the Stars team. The Director sets and directs the enterprise Stars improvement strategy and develops initiatives that advance clinical quality and member experience goals. Partnering closely with senior leaders across the Medicare Advantage and Enterprise Clinical Strategy businesses, the Director ensures that broader organizational efforts are aligned to accelerate and sustain Stars performance.

Job Description

Key Responsibilities /Duties – what you will be doing:

Lead the Medicare Stars team, including analytics, program management, and outreach; direct the overall Stars improvement strategy by identifying strategic focus areas, planning and executing initiatives, and allocating and monitoring the program budget

Collaborate with senior leaders to communicate Stars performance, align priorities, and obtain organization-wide buy-in on new initiatives

Oversee organization-wide socialization of Medicare Stars program performance and CMS regulatory updates

Represent the Medicare Stars program in provider Joint Operating Committees, in partnership with the provider team Partner with the VP, Medical Affairs on CMS advocacy and planning, and oversee CMS submissions and interactions

Drive cultural transformation and organization-wide awareness of Medicare Stars Lead and influence across a complex matrixed organization without direct authority, building alignment, accountability, and commitment among cross-functional partners to advance enterprise Stars priorities.

Partner across the organization to expand and enhance the program’s analytic scope, strengthening predictive insights into Star measure performance and the impact of improvement initiatives.

Maintain a close pulse on Medicare Advantage and Stars market insights, including competitive intelligence and emerging market trends

Qualifications – what you need to perform the job Education (required):
Bachelor's degree

Education (highly preferred):
Master's degree, such as an MPH or MBA Certification and Licensure

Experience7+ years of Medicare Advantage and/or Stars experience, or 3+ years in health care consulting with a top tier consulting firm. Demonstrated success as a strategic leader who collaborates across multiple business functions and drives change

Skill Requirements Strategic planning

Executive communication

Cross-functional leadership

Clinical operations

Regulatory compliance

Data-driven decision making

Change management

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel) :

Must be able to work under normal office conditions and work from…