Become a part of our caring community and help us put health first
 

The Stars Enterprise Activation Principal coordinates, implements, and manages oversight of the company's Medicare/Medicaid Stars Program for aligned areas. The Stars Improvement Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.

This role is responsible for supporting the Stars strategy within Insurance Operations, serving as a subject matter expert for Stars-related initiatives, and ensuring their effective activation and integration throughout the Insurance Operations organization. Insurance Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing, and customer service, each essential to delivering a comprehensive and high-quality member experience.

In this role, you will identify and engage with each area under Insurance Operations that has Stars-related initiatives to understand the business strategy, scope, and goals, building a working knowledge to inform identification and validation of potential synergies, business-specific requirements, risks, and integration paths. This role will collaborate with key Stars and segment business partners to monitor existing work, gain alignment on cross-asset integration opportunities, identify and implement new initiatives, and measure the value of the work.  In addition, this role will support the inventory of existing Stars initiatives and help to identify gaps and opportunities for greater collaboration across segments. This role requires a deep understanding of operations and how it connects with enterprise Stars governance and initiatives.

Role Responsibilities:

• Oversight of related budget, vendor relationships, and program/ project management

• Serve as the primary liaison for Stars initiatives within Insurance Operations, building deep operational knowledge of core functional areas (care coordination, quality, billing, claims, and customer service).

• Collaborate with each Insurance Operations function to identify, understand, and align Stars-related business strategies, objectives, and operational requirements.

• Evaluate business processes across Insurance Operations to identify synergies, integration opportunities, and operational risks related to Stars performance and compliance.

• Coordinate with analytics and reporting teams to generate actionable insights, enabling data-driven prioritization of operational improvements that directly impact Stars measures.

• Partner with segment and enterprise Stars leaders to advance cross-functional initiatives, ensuring alignment between operational execution and Stars strategy.

• Maintain a comprehensive inventory of Stars initiatives within Insurance Operations, identifying gaps and facilitating collaboration to maximize impact across all operational areas.

• Lead and support the design, implementation, and optimization of Stars-related programs and processes within Insurance Operations, including performance monitoring and continuous improvement.

• Oversee test-and-learn pilots to validate solutions and measure operational effectiveness, using results to inform broader implementation.

• Develop and deliver regular reports on Stars operational performance to executive leadership, providing clear visibility into progress, challenges, and opportunities.

• Manage budgets, vendor relationships, and project plans to support the successful delivery of Stars-focused operational initiatives.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree

• 8-9 + years of quality improvement, developing & advancing enterprise strategy, insurance operations experience, i.e.: claims, UM, CM, call center, enrollment, etc.   

• 5 years or more of CMS Stars program experience

• Medicare Advantage experience

• Previous leadership experience as a people leader, leading through influence, or leading complex projects with engagement from multiple areas of the company

• Demonstrated track record of ability to tell the story, influence leaders and drive improvement activity in a matrixed organization

• Strong executive presence

• Ability to navigate business intelligence tools to review data insights & making data driven decisions

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint

Preferred Qualifications

• Master’s Degree