Director, CAHPS and HOS Strategy and Execution
About The Position
Alignment Health is seeking a leader to manage the tactical delivery, operational execution, and performance outcomes of its Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) programs. Reporting to the VP of Stars, the role translates enterprise strategy into actionable provider-level interventions, with the goal of improving member experience and achieving 5-Star ratings. The position owns operational roadmaps, provider engagement playbooks, and day-to-day data cycles that inform performance decisions, working with internal teams and external provider partners. The role requires a consistent field presence of at least 60% for in-person provider engagement, performance reviews, and onsite implementation. It also oversees assigned staff and serves as an internal subject matter expert on CAHPS and HOS methodologies, CMS Star Ratings, regulatory changes, and CMS guidance. The position requires executive autonomy and the ability to communicate performance insights to senior leadership.
Requirements
- 10 or more years of progressive leadership experience in healthcare quality, member experience, and provider performance improvement.
- Experience in health plans, provider organizations, or quality-focused healthcare settings.
- A proven track record of improving CAHPS/HOS metrics in a Medicare Advantage environment.
- Hands-on experience driving provider engagement, with demonstrated CAHPS and HOS performance improvement results.
- Working knowledge of provider contracting, particularly integrating Quality/Stars components into agreements to optimize CAHPS and HOS outcomes.
- Bachelor’s degree in Public Health, Healthcare Administration, Business, or a related field.
- Deep understanding of CAHPS and HOS methodologies, CMS Star Ratings, and quality improvement frameworks.
- Ability to lead cross-functional initiatives and deliver measurable improvements in member experience.
- Effective written and oral communication skills and ability to maintain constructive relationships with diverse members, management, employees, and vendors.
- Ability to perform mathematical calculations and calculate simple statistics correctly.
- Ability to prioritize multiple tasks and apply advanced problem-solving and reasoning, including defining problems, collecting data, establishing facts, drawing conclusions, and designing and managing appropriate resolutions.
- Effective problem-solving, organizational, and time-management skills, and ability to work in a fast-paced environment.
- Ability to comprehend and analyze statistical reports.
- Availability for consistent field presence, with a minimum of 60% devoted to in-person provider engagements, performance reviews, and onsite implementation.
- Ability to execute enterprise CAHPS and HOS strategy with minimal supervision and communicate complex data insights to executive leadership.
- Ability to meet the physical demands of the role, including regularly talking or hearing, standing, walking, sitting, handling objects or controls, reaching, and frequently lifting or moving up to 10 pounds; close vision and ability to adjust focus are required. Reasonable accommodations may be made.
Nice To Haves
- Master’s degree.
Responsibilities
- Translate enterprise-wide CAHPS and HOS strategies into operational roadmaps and manage the project lifecycle for member experience initiatives.
- Direct the annual refresh, maintenance, and field implementation of the Provider Playbook, ensuring interventions for CMS Access to Care domains are carried out at clinic and group levels.
- Analyze CAHPS and HOS data and performance metrics to identify trends and improvement opportunities, and develop action plans with operational leaders and network providers.
- Maintain a field presence of at least 60% to conduct in-person provider performance reviews and ensure onsite implementation meets intervention KPIs.
- Use provider partnerships and high-impact providers to improve member experience.
- Implement and monitor provider incentive programs aligned with measurable improvements in CAHPS and HOS results, and communicate field feedback on incentive impact.
- Collaborate with Stars, Member Services, Member Retention, Network Management, and Quality teams to improve member satisfaction touchpoints.
- Serve as a subject matter expert on CAHPS/HOS survey methodologies and regulatory changes, ensuring compliance with CMS guidance.
- Prepare concise, performance-focused updates for senior leadership, documenting accountability for performance changes and the ROI of interventions.
- Promote service excellence, empathy, and continuous improvement.
- Perform other duties and projects as assigned.
- Oversee assigned staff, including recruiting, selecting, orienting, training, assigning workload, monitoring and appraising results, and coaching, counseling, and performance management.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
