Medicare STARS Director

Intermountain Health

4d • $78 - $120 • Remote

About The Position

This leader provides strategic and operational leadership for the organization’s Medicare Advantage Star Ratings program. This role is accountable for the development, execution, and continuous improvement of initiatives that drive performance across all CMS Star measures, including clinical quality, pharmacy, member experience, and operational metrics. The leader partners across clinical, operational, analytic, and compliance functions to ensure alignment with CMS requirements, sustained quality improvement, and achievement of targeted Star Ratings performance. This position can be performed remotely with business travel as-needed. Intermountain and Select Health maintain employment registration in Utah, Idaho, Nevada, Colorado, and Montana. Candidates in other locations may be considered. Currently, we are not hiring remote workers in the following states: CA, CT, HI, IL, NY, RI, VT, and WA. Please note that a video interview through Microsoft Teams will be required as well as onsite interviews and/or meetings. The Medicare STARS Program Director leads the enterprise-wide strategy and execution of the Medicare Advantage Star Ratings program. This position serves as the central point of coordination for performance improvement activities, governance, reporting, and vendor oversight related to CMS Star Ratings. The Senior Director translates regulatory requirements and performance analytics into actionable strategies, drives cross-functional accountability, and ensures operational readiness for all Star-related submissions, audits, and validations. This role requires advanced knowledge of Medicare Advantage regulations, strong analytical capabilities, and the ability to influence outcomes across multiple departments without direct authority.

Requirements

• Strategic Planning
• Analytical skills
• Presentation
• Written and verbal communication
• Leadership
• Data management
• Budgeting
• Operations management
• Customer satisfaction
• Member engagement
• Regulatory compliance
• Ten (10) or more years of progressive experience in Medicare Advantage, managed care, or highly regulated healthcare environments.
• Seven (7) or more years of direct leadership responsibility for Medicare STARS, quality improvement, HEDIS, CAHPS, Part D, or enterprise performance management.
• Demonstrated success leading Star Ratings improvement or recovery efforts in complex or underperforming environments.
• Proven track record of improving or sustaining 4-Star or higher performance, or leading material performance recovery efforts.
• Experience managing enterprise vendor portfolios, including HEDIS, CAHPS, pharmacy analytics, MTM, and member experience platforms, with clear performance accountability.
• Direct experience supporting CMS audits, data validations, corrective action plans, and regulatory inquiries related to Star Ratings.
• Experience influencing senior executives, Boards, providers, and cross-functional leaders to achieve measurable performance outcomes.
• Strong analytical orientation with experience leveraging data to inform strategy, investment decisions, and operational execution.
• Exceptional executive communication, presentation, and stakeholder-management skills.

Nice To Haves

• Experience in a provider-sponsored health plan, integrated delivery system, or value-based care environment, with strong provider partnership models.
• Experience leading large-scale change management initiatives impacting clinical, operational, and member-facing workflows.

Responsibilities

• Develops and implement a multi-year Medicare STARS strategy aligned with organizational goals and financial performance.
• Leads the STARS workplan, including prioritization of measures, intervention design, timelines, and performance targets.
• Serves as the accountable owner for performance across all CMS Star measures, including HEDIS, CAHPS, Part D, and operational metrics.
• Establishes and lead STARS governance structures, including executive steering committees and cross-functional workgroups.
• Monitors and manages to CMS regulatory guidance, Technical Notes, and cut-point trends; translating those requirements into operational and clinical action plans.
• Oversees performance monitoring, forecasting, and reporting, including leading indicators and risk identification.
• Partners with Analytics, Clinical Operations, Pharmacy, Provider Relations, Member Experience, Compliance, and Finance teams to drive measurable improvement.
• Manages relationships with external vendors supporting STARS performance, including HEDIS, CAHPS, pharmacy analytics, MTM, and member experience partners.
• Communicates performance results, risks, and opportunities to senior leadership in a clear and actionable manner.

Benefits

• In addition to the annual salary, to show our commitment to you and assist with your transition,, we may offer a sign-on and relocation bonus when applicable.
• With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity.
• The AP4P award opportunities are calculated as a percentage of your base salary.
• Awards are paid out based on attainment of selected Board-approved goals.
• We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
• Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees