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. Learn more about who we are at Point
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Health.

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.

• 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.

• Education (required):
  Bachelor's degree
• Education (highly preferred):
  Master's degree, such as an MPH or MBA
• Certification and Licensure
• Experience 7+ 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

Must be able to work under normal office conditions and work from home as required. Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for…