Sr. Director, Clinical Quality - Medicare Stars

Blue Shield of CA; Springfield Meadows (CA); Hybrid; USD 180,000 - 240,000; Full time

Job summary

Blue Shield of CA in California is seeking a Senior Director, Quality - Medicare STARs to lead STARs strategy, oversee STARs performance across Medicare plans, and drive enterprise quality improvement.

Reporting to the Vice President, Quality, the successful candidate will develop, implement, and maintain the STAR quality framework, align initiatives with the Quality Roadmap, and build high‑performing teams.

Qualifications

• Bachelor's degree or HS diploma with 4 years of additional relevant experience in lieu of degree.
• Master's degree in a relevant field (e.g. MHA, MBA, MPH or similar) is preferred.
• 12 years of prior relevant experience is required.
• 6 years of prior people management experience with direct reports is required.
• Expert knowledge of Medicare STARs required.
• Previous experience leading quality and performance improvement for a health plan.

Responsibilities

• Develop STARs strategy and short- and long-term STARs initiatives.
• Oversee STARs performance for all lines of business in Medicare plans.
• Lead enterprise STARs quality improvement program.
• Align STARs initiatives with the Quality Roadmap and organizational goals.

Skills

Leadership

Medicare STARs

Quality improvement

People management

Strategic planning

Stakeholder management

Education

Bachelor's degree

Master's degree preferred

Job description

Your Role

Reporting to the Vice President, Quality, the Senior Director, Quality - Medicare STARs is a senior leader with expertise in developing STARs strategy, short- and long-term STARs initiatives, and oversight of STARs performance. The position will have responsibility for STARs quality improvement and performance for all lines of business with Medicare plans. You will serve as a strategic leader to develop, implement, and maintain the enterprise STAR quality improvement program in alignment with the overall Quality Roadmap and plan to achieve desired outcomes for members and on the overall impact of STARs performance for the organization at large.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree.
• Master's degree in relevant field (e.g. MHA, MBA, MPH or similar) is preferred.
• 12 years prior relevant experience is required.
• 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports is required.
• Expert knowledge of Medicare STARs required.
• Previous experience leading quality and performance improvement for a health plan.

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.