Medicare Performance Hub Director

Blue Cross and Blue Shield of Kansas Inc.; Washington (District of Columbia); On-site; USD 198,000 - 278,000; Full time

Job summary

Blue Cross Blue Shield Association is seeking a Head of the Medicare Performance Hub to lead the MPH from its Chicago or Washington, DC location. You will drive national performance targets across Stars, Risk Adjustment, and Medical Cost Management, translating insights into actionable guidance for Plans.

You will own governance, establish escalation frameworks, and manage vendor relationships with BHI and IT partners. A BS or equivalent and 12+ years in MA program management are required.

Qualifications

• Experience in Medicare Advantage program management and health plan operations.
• Ability to translate complex analytics into plan-level guidance.
• Strong stakeholder management across Plans, vendors, and national program offices.

Responsibilities

• Lead the Medicare Performance Hub design, governance, and operating model.
• Own escalation, CAPs, and plan performance accountability structures.
• Oversee Stars, RA, and medical cost management analytics and dashboards.
• Coordinate data integration strategies across CMS data types and analytics partners.
• Engage with Plans, CEOs, CFOs, and clinical/analytic staff to drive improvement.

Skills

CMS Star Ratings

Risk Adjustment

Medical Cost Management

Education

BS or equivalent experience

Job description

Blue Cross Blue Shield Association is seeking a Head of the Medicare Performance Hub to lead the MPH from its Chicago or Washington, DC location. You will drive national performance targets across Stars, Risk Adjustment, and Medical Cost Management, translating insights into actionable guidance for Plans.

You will own governance, establish escalation frameworks, and manage vendor relationships with BHI and IT partners. A BS or equivalent and 12+ years in MA program management are required.