Director, Star Quality Program

SCAN; Long Beach (CA); Remote; USD 147,000 - 212,000; Full time

Job summary

A leading organization in senior healthcare is seeking a Director for the Star Quality Program to enhance Medicare Star Ratings performance. The role involves strategic leadership, clinical metrics management, and vendor oversight, emphasizing improving member satisfaction and compliance. Candidates should have significant experience in Medicare managed care and a relevant academic background.

Benefits

Annual employee bonus program

Robust Wellness Program

Generous PTO

11 paid holidays plus 1 floating holiday and 1 birthday holiday

401(k) Retirement Saving Plan with employer match

Tuition reimbursement

Qualifications

• 7+ years in a Medicare managed care organization preferred.
• Strong verbal and written communication skills.
• Ability to analyze and synthesize complex information.

Responsibilities

• Develop and execute strategies for Medicare Stars performance targets.
• Analyze clinical metrics and collaborate on interventions.
• Oversee daily operations related to quality initiatives.

Skills

Leadership

Problem Solving

Strategic Mindset

Communication

Analytical Skills

Education

Bachelor's Degree

Graduate or Advanced Degree

Tools

MS Office

Job description

Join to apply for the Director, Star Quality Program role at SCAN

Join to apply for the Director, Star Quality Program role at SCAN

About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 300,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 45 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 300,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 45 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

The Job

The Director of Stars and Quality will lead initiatives to achieve and sustain exceptional Medicare Star Ratings performance, with a strong focus on clinical quality metrics and prescription drug (Rx) adherence measures. This individual will oversee operational strategies, vendor partnerships, and cross-functional collaboration to drive quality improvement, member satisfaction, and compliance with regulatory requirements.

You Will

Strategic Leadership: Develop and execute strategies to meet and exceed Medicare Stars performance targets. Drive improvement in clinical quality metrics, with a focus on Rx adherence measures (statin use, hypertension medication adherence, etc.). Monitor regulatory updates and ensure compliance with CMS Star Ratings requirements.

Clinical Metrics Management: Analyze performance data and trends for clinical metrics to identify improvement opportunities. Collaborate with clinical teams to develop and implement interventions to enhance outcomes. Lead efforts to optimize medication adherence programs and support pharmacy-related initiatives.

Operational Excellence: Oversee daily operations related to quality initiatives, ensuring seamless execution and alignment with organizational goals. Develop processes to streamline workflows, enhance efficiency, and achieve measurable results. Foster a culture of continuous improvement and accountability across teams.

Vendor Oversight: Manage relationships with external vendors, ensuring contractual obligations and quality deliverables are met. Evaluate vendor performance through established metrics and implement corrective actions when necessary. Serve as the primary liaison between vendors and internal stakeholders, promoting collaboration and alignment.

Cross-Functional Collaboration: Partner with member experience, healthcare services, pharmacy, and IT teams to design and execute initiatives. Communicate performance outcomes and improvement plans to executive leadership and stakeholders. Lead or participate in workgroups to address system-wide challenges affecting Stars performance.

We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your Qualifications

Bachelor's Degree or equivalent experience required.

Graduate Or Advanced Degree Or Equivalent Experience Preferred.

7+ years of experience in a Medicare managed care or provider organization preferred.

7+ years of experience in Medicare Star rating program preferred.

Leadership - Skilled to develops others

Business Insight - In-Depth understanding of the business

Problem Solving - Good problem solving skills

Strategic Mindset - Creates strategies to sustain competitive advantage

Strong verbal and written communication skills.

Ability to analyze and synthesize complex information.

Excellent organizational, decision-making, and multi-tasking skills.

Ability to prioritize multiple and competing tasks, work independently and in a team environment.

Proficient in MS Office.

What's in it for you?

• Base salary range: $147,900.00 to $211,530 per year
• Work Mode - Remote (anticipated travel to Long Beach, CA office is 1-2 times per month)
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!
  
  

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Full-time

Job function

• Job function

  Quality Assurance

• Industries

  Hospitals and Health Care

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