AVP, Stars Quality & Value-Based Care

CVS Health; Springfield (IL); Presencial; USD 158.000 - 364.000; Jornada completa

Descripción de la vacante

Oak Street Health, a CVS Health company, seeks an AVP, Stars to lead quality strategy across centers, with a focus on HEDIS, Stars, and chronic condition management. You will partner with executive, clinical, and field leaders to drive enterprise quality initiatives and improve performance.

You will oversee program design, dashboards, data integration with Epic, and vendor management, while coaching managers and directors toward measurable quality and financial outcomes in a value-based care

Formación

• 10+ years of progressive experience in HEDIS/Stars with at least 5 years in senior leadership at a health plan, MSO, IPA, or value-based medical group.
• Proven track record of improving Stars performance across a large organization to achieve quality bonuses in VBC contracts.
• Deep expertise in CMS Stars methodology, NCQA HEDIS specifications, CAHPS, HOS, and Medicare Advantage economics.
• Experience negotiating and operating value-based contracts and joint operating committees with national and regional health plans.
• Strong command of supplemental data strategy, digital quality measures, and EHR-driven quality workflows (Epic preferred).
• Analytical fluency—ability to interrogate measure-level data, attribution files, and reconciliation reports directly.

Responsabilidades

• Own the multiyear Stars strategy to achieve 4+ Stars across the payer portfolio and reduce financial risk tied to Stars-based contract terms.
• Partner with executive leadership to translate enterprise quality goals into operating plans and annual priorities.
• Develop forward-looking analyses by payer, market, and measure—including cut-point scenarios, run-rate projections, and revenue or penalty exposure.
• Establish a consistent operating cadence—including monthly reviews, weekly external reporting, and divisional deep dives—with defined metrics, owners, and escalation paths.
• Lead teams that design, launch, and scale quality improvement programs focused on gap closure, chronic condition management, preventive care, and Stars performance.
• Promote consistent adoption of quality programs and best practices across all centers and evaluate their impact.
• Oversee care-team incentives, Stars dashboards, worklists, and process metrics, ensuring key measures have clear owners and action plans.
• Evaluate and manage vendors, pilots, and technology solutions that strengthen gap closure, measure capture, and supplemental data submission.
• Partner with Field Operations, Clinical Leadership, Population Health, Patient Journey, and Field Enablement to integrate Stars gap closure into daily clinical and operational workflows.

Conocimientos

HEDIS/Stars

CMS knowledge

Data analytics

Epic workflows

Leadership

Educación

Bachelor’s degree in healthcare / related field

Herramientas

Epic

Descripción del empleo

Oak Street Health, a CVS Health company, seeks an AVP, Stars to lead quality strategy across centers, with a focus on HEDIS, Stars, and chronic condition management. You will partner with executive, clinical, and field leaders to drive enterprise quality initiatives and improve performance.

You will oversee program design, dashboards, data integration with Epic, and vendor management, while coaching managers and directors toward measurable quality and financial outcomes in a value-based care