Remote AVP, Stars & Risk Adjustment Strategy

Humana Inc; Salem (OR); On-site; USD 246,000 - 344,000; Full time

Benefits offered by this job

Bonus incentive plan

Remote work option

Job summary

Humana Inc in the United States seeks an Associate Vice President, Medical Risk Adjustment and Provider Engagement to drive clinical leadership for STARS and Risk Adjustment. You will engage providers, oversee education, and develop KPIs, reporting, and materials for regional leaders and health services teams.

Collaborating with operations, analytics, and compliance, you will ensure compliant, high-quality care delivery while advancing risk adjustment initiatives.

Qualifications

• Advanced clinical degree required.
• Experience in clinical leadership roles, preferably within managed care, risk adjustment, or quality improvement.
• Risk adjustment and Stars experience.
• Proven ability to lead and develop high-performing teams.
• Strong communication and relationship-building skills with provider organizations.
• Experience developing and monitoring KPIs, reporting, and educational programs for healthcare leaders.
• Proficiency in interpreting clinical and quality data to drive performance improvement.

Responsibilities

• Provide clinical leadership across STARS and Risk Adjustment to align with objectives and regulatory requirements.
• Increase provider engagement and satisfaction related to risk adjustment and quality programs.
• Oversee Stars self-reporting metrics with clinical oversight and escalation of issues.
• Participate in CMS audits related to Stars and risk adjustment activities.
• Provide targeted provider education on clinical and operational areas to close Stars gaps.
• Lead a team supporting risk adjustment education and communications.

Skills

Advanced clinical degree (MD, DO)

Clinical leadership experience

Risk adjustment and Stars experience

Leadership of high-performing teams

Strong communication and relationship‑

KPIs, reporting, education programs

Data interpretation for performance

Education

MD or DO

Job description

Humana Inc in the United States seeks an Associate Vice President, Medical Risk Adjustment and Provider Engagement to drive clinical leadership for STARS and Risk Adjustment. You will engage providers, oversee education, and develop KPIs, reporting, and materials for regional leaders and health services teams.

Collaborating with operations, analytics, and compliance, you will ensure compliant, high-quality care delivery while advancing risk adjustment initiatives.