Stars Performance Lead, Clinical Initiatives

L.A. Care; Los Angeles (CA); On-site; USD 135,136 - 216,218; Full time

Benefits offered by this job

PTO

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

L.A. Care Health Plan is seeking a Senior Manager, Stars and Clinical Initiatives in Los Angeles to lead improvement programs for D-SNP and Covered California lines, elevating Stars performance through clinical quality and member outcomes.

The role drives cross-functional collaboration, regulatory updates, and innovative strategies while managing a high-performing team and department budget.

Qualifications

• Required: deep knowledge of Stars, HEDIS, CAHPS, and related quality improvement programs.
• Strong knowledge of CMS and state regulatory standards.
• Excellent analytic skills for Stars data analysis, performance modeling and reporting.
• Ability to work across functions and build collaboration with diverse stakeholders.
• Excellent verbal and written communication and presentation skills.

Responsibilities

• Lead development, implementation, and continuous improvement of clinical and quality improvement programs to elevate Stars performance.
• Collaborate with cross-functional teams to implement evidence-based best practices.
• Serve as Medicare and Covered California Stars subject matter expert and operational leader.
• Analyze data, distill actionable insights, and report to committees and workgroups.
• Stay updated on industry trends including AI applications to improve care and outcomes.
• Engage with external stakeholders to build partnerships that elevate Stars and services for members.
• Identify and manage CMS and state regulatory updates and risks to ensure compliance.
• Oversee department budgets and manage staffing, scheduling, training, and mentoring.
• Foster a culture of transparency, accountability, and enterprise-wide goal achievement.
• Plan and implement systems to maximize operating efficiency and strategic priorities.
• Support Medi-Cal and PASC-SEIU improvement initiatives as needed.

Skills

Stars knowledge

HEDIS

CAHPS

Quality improvement

CMS standards

Data analysis

Stakeholder collaboration

Communication skills

Budgeting

Leadership

Education

Bachelor's Degree

Master's Degree preferred

Job description

L.A. Care Health Plan is seeking a Senior Manager, Stars and Clinical Initiatives in Los Angeles to lead improvement programs for D-SNP and Covered California lines, elevating Stars performance through clinical quality and member outcomes.

The role drives cross-functional collaboration, regulatory updates, and innovative strategies while managing a high-performing team and department budget.