Senior Director, STARS Clinical Design - Remote

UnitedHealth Group•Eden Prairie, MN

3d•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Director, Clinical Design - Stars serves as a senior clinical strategy and product leader for Care at Home (CaH) and Senior Community Care (SCC) risk-based businesses, with primary accountability for designing, scaling, and operationalizing clinical and quality initiatives that improve outcomes and performance across the Medicare Quality and STARS ecosystem. This role is responsible for designing and leading quality initiatives impacting key STARS measures of highest priority to CaH and SCC risk businesses, and other H&CCD businesses that may impact STARS, while integrating those efforts into broader clinical model evolution work wherever possible for risk-based businesses. The leader will partner closely with business, clinical, operational, and enterprise stakeholders to translate quality strategy into executable programs that improve performance across STARS, HEDIS, Part D, CAHPS, and HOS measures. In partnership with business and performance leadership, this role provides strategic direction across clinical model evolution, quality performance, and product enablement, while liaising with Clinical Excellence, Optum Health, and enterprise STARS organizations to drive alignment and execution in a highly matrixed environment. This position requires exceptional leadership, strong clinical design acumen, deep knowledge of the Medicare Quality program, and the ability to influence and execute across complex stakeholder groups. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. For hires in the Minneapolis or Washington, D.C. area, in-office presence may be required a minimum of four days per week, consistent with role and business expectations.

Requirements

8+ years of experience in healthcare product strategy, clinical program design, quality management, or related roles, with prior understanding of the Medicare Quality program (STARS, HEDIS, Part D, CAHPS, and HOS measures)
Experience designing and implementing clinical programs within a payer, Medicare Advantage, or other risk-bearing organization
Demonstrated experience working with and operationalizing programs designed to impact these measures
Proven success leading large-scale, cross-functional initiatives in complex, matrixed environments
Executive communication with the ability to synthesize strategy, performance, and value for senior stakeholders

Nice To Haves

Clinical licensure (MD or RN) with experience in clinical design in a payer or risk-bearing entity driving STARS initiatives
Background in home-based care, care delivery, payer or clinical and operational integration
Expertise in data-driven quality improvement, clinical performance measurement, and analytics-informed decision-making
Experience leveraging technology and training teams to optimize clinical program performance including engagement rates, documentation standards, gap closure performance

Responsibilities

Design and lead implementation for quality initiatives impacting key STARS measures of highest priority to Care at Home (CaH) and Senior Community Care (SCC) risk businesses and other H&CCD businesses that may impact STARS
Own the strategy for improving performance across the Medicare Quality program, including STARS, HEDIS, Part D, CAHPS, and HOS
Translate regulatory, clinical, and quality requirements into scalable, operationally executable programs
Partner with operational leaders to ensure initiatives are effectively implemented, measured, and sustained
Design and prioritize interventions based on business need, performance gaps, and opportunities to improve clinical, operational, pharmacy, and experience-related measures
Integrate STARS and quality initiatives into broader clinical model evolution efforts wherever possible for risk-based businesses
Ensure alignment across clinical workflows, provider engagement, operational execution, and quality outcomes
Influence clinical design decisions to optimize quality performance while maintaining member experience, operational efficiency, and scalability
Define and support the clinical and quality product strategy that enables improved STARS performance and risk outcomes
Partner with product and program leaders to ensure the roadmap includes capabilities that support clinical quality, measurement, reporting, and intervention execution
Guide initiatives from strategy and design through pilot, deployment, and enterprise-scale execution.
Liaise with Clinical Excellence, Optum Health, and enterprise STARS organizations as needed to align priorities, leverage best practices, and reduce duplication
Navigate execution in a highly matrixed environment, balancing enterprise direction with business and market needs
Partner with clinical, operations, product, technology, analytics, finance, growth, and market-facing functions and stakeholders to ensure coordinated prioritization and execution
Serve as a senior subject matter expert for clinical quality and STARS initiatives
Present strategy, progress, risks, and outcomes to executive leadership in forums such as MBRs, QBRs, and enterprise reviews
Provide strategic guidance to a network of dotted-line contributors across product, clinical, program management, and market-facing functions
Foster a culture of collaboration, accountability, and data-driven decision-making