VP, Quality & Stars | Risk Adjustment Performance Ops

Monogram Health Inc; Brentwood (TN); Vor Ort; USD 210.000 - 280.000; Vollzeit

Benefits dieser Stelle

Comprehensive Benefits

401k with employer match

Paid time off: 20 PTO days

7 paid holidays

Floating day

Paid parental leave

Wellness programs

Zusammenfassung

Monogram Health in Brentwood, TN seeks a Vice President, Quality, Stars, Risk Adjustment and Performance Operations to lead enterprise strategy and execution across products, with emphasis on Medicare Advantage, quality, HEDIS, and risk adjustment. You will orchestrate cross-functional workflows, establish accountability, and drive measurable performance results.

The role requires a decade of healthcare leadership, including Medicare Advantage Stars/Risk Adjustment, and the ability to build

Qualifikationen

• Bachelor’s degree required; master’s degree in healthcare, business, public health, or a related field preferred.
• Minimum of ten years healthcare leadership experience, including at least five years leading Medicare Advantage Stars, Quality, HEDIS, Risk Adjustment.
• Ability to build and lead large-scale operational teams in a matrixed environment.

Aufgaben

• Lead enterprise strategy and end-to-end performance for Quality, Stars, HEDIS, Risk Adjustment, and clinical documentation improvement.
• Set annual and long-range goals, operating plans, milestones, and accountability, and drive execution and corrective action across the organization.
• Develop payer specific strategies that reflect contractual requirements, performance methodologies, financial incentives, data availability, and operational opportunities.
• Own trusted scorecards, forecasts, and reporting with clear definitions, validated data, and reconciliation across clinical, payer, CMS, and financial sources.
• Partner with Finance, Actuarial, and Medical Economics to quantify and forecast the revenue, medical cost, and margin implications of performance.
• Translate opportunities into scalable clinical and operational workflows by defining requirements and priorities for clinical, product, analytics, and technology teams.
• Lead governance and executive reviews, remove barriers, resolve competing priorities, and hold internal teams and external partners accountable for results.
• Manage payer relationships and external partners, including data and methodology issues, contractual discussions, implementation, service levels, and measurable return on investment.
• Oversee coding, clinical documentation integrity, audit, and data submission controls, ensuring regulatory compliance, audit readiness, remediation, and effective feedback loops.
• Build and retain a high performing multidisciplinary team and educate stakeholders on regulatory, Stars, HEDIS, and risk model changes and their operational and financial implications.

Kenntnisse

Healthcare leadership

Analytical skills

Financial acumen

Regulatory compliance

Stars knowledge

Ausbildung

Bachelor’s degree

Master’s degree in healthcare/business/public health

Jobbeschreibung

Monogram Health in Brentwood, TN seeks a Vice President, Quality, Stars, Risk Adjustment and Performance Operations to lead enterprise strategy and execution across products, with emphasis on Medicare Advantage, quality, HEDIS, and risk adjustment. You will orchestrate cross-functional workflows, establish accountability, and drive measurable performance results.

The role requires a decade of healthcare leadership, including Medicare Advantage Stars/Risk Adjustment, and the ability to build