Director, Stars HOS Improvement and Operations

Humana • Mansfield, TX

260d • $150,000 - $206,300 • Remote

About The Position

Be a part of our caring community and help us put health first. Health Quality and Stars (HQS) is an organization that is responsible for improving health outcomes and advancing the care experience of our members and provider partners through quality solutions. HQS is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations. The Director, Stars HOS Improvement and Operations is responsible for overseeing the implementation, management, and continuous improvement of the Health Outcome Survey (HOS) initiatives as part of the CMS Stars Program. This role is responsible for driving performance on key HOS-based quality measures and shaping future direction through insight-driven recommendations and improvement interventions.

Requirements

• Bachelor's Degree
• 8+ years of experience in Medicare Advantage quality, Stars and/or member experience
• 3 years or more of management experience
• Strong operational and project management skills, with a track record of performance improvement
• Experience driving enterprise strategy
• Exceptional communication, collaboration, and influence skills
• Analytical mindset with ability to interpret data and generate strategic insights

Nice To Haves

• Masters degree
• Deep understanding of HOS survey methodology, Stars weighting, and CMS expectations

Responsibilities

• Serve as an internal expert on HOS survey methodology, regulatory changes, and CMS guidance
• Monitor HOS results, identify areas of opportunity, and drive continuous improvement
• Accelerate accountability for HOS improvement by driving enterprise strategy and operational initiatives to improve performance on HOS-based Stars measures, including improving physical and mental health
• Develop and maintain a portfolio of improvement initiatives focused on delivering improved member experience and health outcomes, targeting key drivers of HOS performance
• Collaborate with cross-functional teams (clinical operations, care management, member engagement, analytics) to design and implement targeted interventions addressing HOS domains
• Responsible for initiative performance monitoring and development of deep, holistic operational reporting, with regular executive summary roll-up to Stars leadership
• Lead multiple analytics partners to develop robust reporting informing prioritized opportunities for Quality improvement and experience; requires ability to derive insights from large quantities of data
• Develop strategic recommendations for program evolution and policy advocacy, including written summaries and talking points for engagement with CMS, industry groups, and internal stakeholders
• Oversee budget, vendor relationships and project/program management
• Lead and develop team of high-performing direct reports

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Paid time off, including company and personal holidays, volunteer time off, paid parental and caregiver leave
• Short-term and long-term disability
• Life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree