Associate VP, Stars & Risk Adjustment & Provider Engagement

Humana Inc; Topeka (KS); On-site; USD 246,000 - 344,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) retirement plan

Paid time off

Short-term & long-term disability

Life insurance

Job summary

Humana, Inc. is seeking an Associate Vice President to lead Medical Risk Adjustment and Provider Engagement. This executive will guide clinical strategy, engage providers, oversee risk education, and define KPIs, reporting, and education for regional leaders.

The role emphasizes legal/regulatory compliance, performance improvement, and cross-functional collaboration with operations, analytics, and compliance teams. Travel may be required.

Qualifications

• Advanced clinical degree (MD, DO) required.
• Demonstrated experience in clinical leadership roles, preferably in managed care or quality improvement.
• Experience with risk adjustment and Stars programs.
• Proven ability to lead and develop high-performing teams.
• Strong communication and relationship-building skills with provider organizations.
• Experience developing and monitoring KPIs, reporting, and educational programs for healthcare leaders.
• Proficiency in interpreting clinical and quality data to drive performance improvement.

Responsibilities

• Provide clinical guidance across STARS and Risk Adjustment initiatives to align with objectives and regulations.
• Increase provider engagement and satisfaction related to risk adjustment and clinical quality programs.
• Serve as overseeing medical director for Stars self-reporting metrics and interpret, escalate issues requiring physician leadership.
• Participate in CMS audits related to Stars and risk adjustment activities.
• Provide targeted provider education to close Stars gaps and improve quality measures.
• Lead and manage a team supporting risk adjustment education and communications.
• Develop, implement, and monitor KPIs for executives and health services directors.

Skills

Clinical leadership

Provider engagement

KPIs & reporting

Communication & relationships

Data interpretation

Education

MD/DO

Job description

Humana, Inc. is seeking an Associate Vice President to lead Medical Risk Adjustment and Provider Engagement. This executive will guide clinical strategy, engage providers, oversee risk education, and define KPIs, reporting, and education for regional leaders.

The role emphasizes legal/regulatory compliance, performance improvement, and cross-functional collaboration with operations, analytics, and compliance teams. Travel may be required.