AVP, Stars - Oak Street Health

CVS Health•Work At Home-Illinois, IL

9d•$157,800 - $363,936

About The Position

Oak Street Health, a CVS Health company, is committed to delivering high-quality care to older adults on Medicare, particularly in underserved communities. We focus on the kind of healthcare you'd want for your own family—personalized, accessible, and effective. Our mission is to rebuild healthcare around wellness and positive outcomes, not volume. Through dedicated care teams, we take the time to understand each patient and provide the support they need to live healthier, fuller lives. We emphasize value-based care, particularly full-risk/capitated models, and leverage care management strategies to improve clinical and financial outcomes. The AVP, Stars will lead Oak Street Health’s quality strategy and programs to improve HEDIS, Stars, and chronic condition management performance. In partnership with executive, clinical, operational, and field leaders, this role will implement enterprise quality initiatives, track results, and drive continuous improvement across Oak Street Health centers. Through disciplined program management, analytics, and cross-functional collaboration, the AVP will advance quality, operational, and financial outcomes.

Requirements

10+ years of progressive experience in HEDIS, Stars, and or Documentation with at least 5 years in senior leadership at a health plan, MSO, IPA, or value-based medical group.
Proven track record of improving Stars performance across a large organization to achieve quality bonuses in VBC contracts.
Deep expertise in CMS Stars methodology, NCQA HEDIS specifications, CAHPS, HOS, and Medicare Advantage economics.
Experience negotiating and operating value-based contracts and joint operating committees with national and regional health plans.
Strong command of supplemental data strategy, digital quality measures, and EHR-driven quality workflows (Epic preferred).
Analytical fluency—ability to interrogate measure-level data, attribution files, and reconciliation reports directly.
Experience leading large, multi-disciplinary teams across clinical and non-clinical functions, with a focus on engagement, accountability, and results.
Entrepreneurial spirit—comfortable navigating ambiguity, driving innovation, and rolling up sleeves to solve problems.
Exceptional communication and relationship-building skills, with the ability to influence stakeholders at all levels.
Bachelor's Degree or equivalent combination of education and relevant work experience.

Responsibilities

Own the multiyear Stars strategy to achieve 4+ Stars across the payer portfolio and reduce financial risk tied to Stars-based contract terms.
Partner with executive leadership to translate enterprise quality goals into operating plans and annual priorities.
Identify opportunities across Stars, HEDIS, and chronic condition management; recommend interventions; and set targets aligned with organizational quality goals.
Develop forward-looking analyses by payer, market, and measure—including cut-point scenarios, run-rate projections, and revenue or penalty exposure—and translate findings into clear priorities for the COO and executive team.
Establish a consistent operating cadence—including monthly reviews, weekly external reporting, and divisional deep dives—with defined metrics, owners, and escalation paths.
Lead teams that design, launch, and scale quality improvement programs focused on gap closure, chronic condition management, preventive care, and Stars performance.
Promote consistent adoption of quality programs and best practices across all centers and evaluate their impact.
Oversee care-team incentives, Stars dashboards, worklists, and process metrics, ensuring key measures—including cancer screenings, eye exams, diabetes control, and medication adherence—have clear owners and action plans.
Evaluate and manage vendors, pilots, and technology solutions that strengthen gap closure, measure capture, and supplemental data submission.
Partner with Field Operations, Clinical Leadership, Population Health, Patient Journey, and Field Enablement to integrate Stars gap closure into daily clinical and operational workflows.
Support divisional, regional, and center leaders in identifying performance barriers and implementing corrective actions, with targeted assistance for markets facing the greatest Stars risk.
Collaborate with care teams to improve patient outcomes and experiences.
Represent Oak Street Health’s Stars strategy in executive payer meetings and joint operating committees with national and regional health plans.
Partner with Managed Care Operations to assess payer contract quality provisions, support performance discussions, and provide expertise on new and existing arrangements.
Implement payer-specific quality programs and reporting requirements.
Guide data reconciliation with payers, resolve discrepancies, and appeal results when appropriate.
Build trusted payer relationships that position Oak Street Health as a quality-focused partner and a preferred value-based care model for expansion.
Maintain and enhance dashboards that provide visibility into performance, trends, and targets across Stars, HEDIS, and chronic condition management measures.
Ensure Stars data is accurate, timely, and complete across claims, EHR, HIE/ADT, supplemental, and payer-provided sources.
Use data to identify opportunities, prioritize actions, and evaluate results.
Monitor upcoming CMS rules, Stars methodology changes, and measure transitions, and assess their potential impact on Oak Street Health.
Partner with technology, product, and clinical informatics teams to optimize Epic workflows for quality performance.
Identify system enhancements that streamline provider workflows and improve quality measure capture and reporting accuracy.
Support implementation of new quality technology and partner with Engineering and Analytics on data ingestion, user acceptance testing, and submission processes.
Lead, develop, and retain managers, senior analysts, and directors by setting clear expectations, coaching for high performance, and building a strong succession pipeline.