Director, Clinical Quality (Medicare Stars)

HITEC

Long Beach (CA)

Hybrid

USD 180,000 - 240,000

Full time

2 days ago
Be an early applicant

A complete application in a minute

Tailored resume and cover letter, ready to send.

Get past ATS filters

Job summary

HITEC is seeking a Director of Clinical Quality - Medicare Stars to lead the HEDIS strategy, execution, and performance oversight, driving initiatives to improve star ratings, health outcomes, and member experience. The role directs the clinical quality roadmap and oversees performance across multiple contracts, requiring deep expertise in Stars, HEDIS, CMS requirements, and strong stakeholder engagement.

This hybrid role values leaders who foster learning, build high-performing teams, and

Qualifications

  • 10 years of healthcare experience leading large cross-functional quality programs.
  • 6 years of people management with direct reports.
  • 6 years of Stars and HEDIS initiative leadership.
  • Experience with CMS requirements and Medicare Advantage quality programs.
  • Strong analytic skills to derive insights from healthcare data.

Responsibilities

  • Lead Medicare Stars HEDIS strategy and performance oversight.
  • Oversee the clinical quality roadmap and operational excellence.
  • Collaborate across clinical and operational teams to drive system change.

Skills

Stars & HEDIS expertise
Healthcare data analytics
Cross-functional leadership
Executive communication
Project management
Medicare Advantage quality programs

Education

Bachelor's degree
MPH or MHA preferred

Job description

Your Role

The Director of Clinical Quality - Medicare Stars reports to the Senior Director of Clinical Quality and leads the organization’s Medicare Stars HEDIS strategy, execution, and performance oversight. This role is critical to maintaining and improving Medicare Star Ratings and HEDIS performance by driving initiatives focused on clinical gap closure, quality improvement, health outcomes, and member experience.

The Director will oversee the clinical quality strategic roadmap, operational excellence, and performance oversight of multiple H-Contracts and future Medicare Advantage contracts. The position requires a dynamic leader with deep expertise in Stars, HEDIS, and quality improvement methodologies, as well as the ability to collaborate across clinical and operational functions to enhance performance outcomes and drive systemic change.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience
  • Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
  • Master’s in Public Health (MPH), Healthcare Administration (MHA), or related field is preferred.
  • 10 years of healthcare experience leading large-scale, cross-functional programs focused on quality improvement.
  • 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
  • 6 years of direct experience managing Stars and HEDIS performance initiatives with proven success in driving improvements.
  • Strong ability to interpret complex healthcare data, develop insights, and apply analytics-driven strategies.
  • Experience in Medicare Advantage quality programs, CMS requirements, and industry-leading Stars & HEDIS performance improvement techniques.
  • Exceptional communication skills, with the ability to engage executive leadership, providers, and stakeholders effectively.
  • Strong project management skills, with the ability to navigate tight deadlines, manage competing priorities, and lead strategic initiatives successfully.
Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

Get your free, confidential resume review.

or drag and drop your file here.

Similar jobs

Similar jobs worth comparing

Director, Clinical Quality (Medicare Stars)
Director, Clinical Quality (Medicare Stars)

Blue Shield of CA • San Diego (CA)

Hybrid
USD 180,000 - 280,000
Director, Clinical Quality (Medicare Stars)
Director, Clinical Quality (Medicare Stars)

Blue Shield of CA • Oakland (CA)

Hybrid
USD 180,000 - 240,000
Director, Clinical Quality (Medicare Stars)
Director, Clinical Quality (Medicare Stars)

Blue Shield of CA • Long Beach (CA)

Hybrid
USD 180,000 - 260,000
Director of Medicare Stars & HEDIS Quality Improvement
Director of Medicare Stars & HEDIS Quality Improvement

HITEC • Long Beach (CA)

Hybrid
USD 180,000 - 240,000
Director, Medicare Stars & HEDIS Quality
Director, Medicare Stars & HEDIS Quality

Blue Shield of CA • San Diego (CA)

Hybrid
USD 180,000 - 280,000
Director Medicare Stars
Director Medicare Stars

Morgan Consulting Resources, Inc. - Healthcare Executive Search • Rancho Cucamonga (CA)

Hybrid
USD 120,000 - 150,000
Medicare Stars & HEDIS Quality Director
Medicare Stars & HEDIS Quality Director

Blue Shield of California • California

Hybrid
USD 160,000 - 240,000
Director of Medicare Stars & HEDIS Quality Improvement
Director of Medicare Stars & HEDIS Quality Improvement

Blue Shield of CA • Long Beach (CA)

Hybrid
USD 180,000 - 260,000
Director Medicare Stars Strategy
Director Medicare Stars Strategy

P32HS Point32Health Services Inc • Canton (MA)

Remote
USD 146,000 - 219,000
Director of Medicare Stars & HEDIS Quality Improvement
Director of Medicare Stars & HEDIS Quality Improvement

Blue Shield of CA • Oakland (CA)

Hybrid
USD 180,000 - 240,000