Director Medicare Stars Strategy

Socket.dev; Canton (MA); Hybrid; USD 146,000 - 219,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Retirement plans

Paid time off

Life and disability insurance

Tuition program

Well-being benefits

Job summary

Point32Health seeks a Director, Medicare Stars Strategy to lead enterprise Stars initiatives and set the strategic direction for Medicare Advantage performance. This role collaborates with senior leaders to drive quality improvements, member experience, and CMS alignment.

You will guide analytics, program management, and communications across a matrixed organization, ensuring timely execution and measurable impact on Star measures and regulatory updates.

Qualifications

• Bachelor's degree is required.
• Master's degree preferred (MPH or MBA).
• 7+ years in Medicare Advantage and/or Stars, or 3+ years in health care consulting with a top tier firm.

Responsibilities

• Lead the Medicare Stars team, including analytics, program management, and outreach; direct the overall Stars improvement strategy and monitor 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 with the provider team.
• Partner with the VP, Medical Affairs on CMS advocacy and planning, and oversee CMS submissions/interactions.
• Drive cultural transformation and organization-wide awareness of Medicare Stars.
• Lead and influence across a complex matrixed organization without direct authority, building alignment and accountability.
• Expand analytical scope to strengthen predictive insights into Star measure performance and impact of interventions.

Skills

Strategic planning

Executive communication

Cross-functional leadership

Clinical operations

Regulatory compliance

Data-driven decision making

Change management

Education

Bachelor's degree

Master's degree (MPH or MBA)

Job description

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health 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.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

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.

Job Description

Key Responsibilities/Duties – what you will be doing:

• 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

Qualifications – what you need to perform the job

• 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

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

• 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 extended durations.
• May be required to work additional hours beyond standard work schedule.
• Anything specific to physical needs (lifting etc.)

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Salary Range

$145,958.40 -$218,937.60

Compensation & Total Rewards Overview

The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation andbenefits remains in the Company's sole discretion and maybe modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

We welcome all

All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.