Medicare Performance Hub Director - Remote Leadership

Blue Cross Blue Shield Association; United States; Remote; USD 198,000 - 278,000; Full time

Benefits offered by this job

Annual bonus eligibility

Health/dental/vision insurance

401(k) matching

Job summary

Blue Cross Blue Shield Association is seeking a Senior Director to lead the Medicare Performance Hub, driving Stars, Risk Adjustment, and Medical Cost Management performance. This executive role oversees governance, analytics, vendor partnerships, and plan engagement to translate national insights into local action.

The MPH leads operationalization of dashboards, benchmarks, and target-setting while coordinating with Plans, BHI, and analytics partners.

Qualifications

• Requires deep expertise in Medicare Advantage performance areas (Stars, RA/HCC coding, medical cost management).
• Demonstrated ability to manage complex, multi-stakeholder programs with health plans, analytics vendors and a national program office.
• Excellent written/verbal communication and project management skills for executive audiences.
• Ability to translate data insights into actionable, plan-level guidance and engagement led by Plan CEOs and senior leaders.
• Experience with data integration, governance and vendor relationships in a national Blue Plan context.

Responsibilities

• Lead the design, implementation and ongoing management of the Medicare Performance Hub.
• Translate national program insights into Plan-specific action plans and consultative engagement.
• Establish MPH governance, escalation pathways and performance accountability with Plans and vendors.
• Engage Plan executives and Plan CEOs in governance and performance reviews.
• Monitor Stars, RA, and Medical Cost performance and drive data-driven improvements across Plans.

Skills

CMS Star Ratings

Risk Adjustment

Medical Cost Management

Vendor management

Education

BS or equivalent experience

MS in Health Administration or related field

Tools

VRDC

NDW

CMS data platforms

Job description

Blue Cross Blue Shield Association is seeking a Senior Director to lead the Medicare Performance Hub, driving Stars, Risk Adjustment, and Medical Cost Management performance. This executive role oversees governance, analytics, vendor partnerships, and plan engagement to translate national insights into local action.

The MPH leads operationalization of dashboards, benchmarks, and target-setting while coordinating with Plans, BHI, and analytics partners.