Principal, Stars Care Coordination

Humana • New York, NY

3d • Remote

About The Position

Become a part of our caring community and help us put health first We are looking for a dynamic Strategy Execution/Advancement Principal for Care Coordination to develop clinical solutions for our members and providers, with full accountability from strategy to execution. The Principal for Stars Care Coordination, Provider Strategy is responsible for developing, executing, and optimizing strategies that engage hospital systems and provider groups to improve performance on key Stars Care Coordination measures. The role will design and implement financial incentive programs targeted at reducing Plan All-Cause Readmission rates and enhancing provider performance on metrics such as Post-Discharge Physician Visit Rate (PCR), Follow-Up after Mental Health Hospitalization (FMC), and Timely Receipt of Care (TRC). Additionally, the incumbent will support performance management initiatives to drive measurable improvements across both hospitals and provider networks.

Requirements

• Bachelor’s degree
• 8 or more years of experience in management consulting, population health strategy, health outcomes strategies and/or provider practice management
• 2 - 5 years or more of project/people leadership experience
• Strong understanding of transitional care management
• Experience working directly with provider groups, clinical leaders, or care teams
• Experience in advanced primary care or high-performance provider models
• Strong data literacy with demonstrated experience using analytics to drive operational insights
• Excellent communication, relationship-building, and cross-functional collaboration skills
• Ability to independently manage complex initiatives, work across departments, and drive execution without day-to-day oversight

Nice To Haves

• Experience with population health workflows and drivers of 30-day readmissions
• Experience in management consulting and clinical practice (ideal but not required)
• Expertise in provider workflow optimization, care transitions, or readmission reduction programs
• Familiarity with EHR workflows and system integrations
• Demonstrated ability to translate analytics into operationally executable solutions

Responsibilities

• Lead the design, implementation, and evaluation of financial incentive programs for hospital systems to reduce Plan All-Cause Readmission rates.
• Develop and manage incentive structures for providers to improve performance on PCR, FMC, and TRC metrics.
• Partner with internal and external stakeholders to ensure alignment of incentive programs with organizational goals and compliance requirements.
• Provide guidance and support to hospitals and providers in understanding Stars Care Coordination measures and best practices for performance improvement.
• Monitor, analyze, and report on the effectiveness of financial incentive programs and overall provider performance against Stars metrics.
• Support the development and execution of performance management strategies for both hospitals and providers, including performance tracking, feedback, and intervention.
• Collaborate cross-functionally with clinical, operational, and analytics teams to ensure coordinated efforts toward Stars rating improvement.
• Stay current with industry trends, CMS guidelines, and best practices related to Stars Care Coordination and value-based incentive programs.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Principal