Stars Program Delivery Lead – Colon Cancer Screening

Humana

4d • $115,200 - $158,400 • Hybrid

About The Position

The Stars Program Delivery Lead strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Program Delivery Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This role is remote, but if in driving distance to the Louisville office, it will be hybrid. The position requires in-depth and broad knowledge of HEDIS measures to develop strategy and implement comprehensive solutions to drive overall Stars performance. Key responsibilities include accountability for performance and operational excellence of comprehensive programs to improve Star ratings, partnering with multiple analytics teams to develop, prioritize, deliver, and measure solutions, and proactively engaging stakeholders to anticipate headwinds and identify gaps. The role also involves providing insights and identifying new opportunities for improvement through data analysis, making recommendations based on reporting and monitoring, and cross-collaboration with the performance management team. Additionally, the Lead will conduct audits of data collection and processes, create standard operating procedures, and support key functions with strategic and analytical thinking, including understanding Stars operations, technical specifications, and HEDIS measures. Problem-solving skills are essential for navigating a fast-paced, complex environment, and insights into campaign development, market needs, and clinical settings are valuable for improving performance and advancing provider strategies.

Requirements

• Bachelor’s Degree or equivalent work experience
• 7 or more years of operations, program management, clinical and/or strategy experience
• 2+ Medicare Stars and HEDIS knowledge or experience
• Experience leading special projects and producing metrics, measurements and reports
• Proficiency in interpreting data trends and applying to operations
• Demonstrated ability to articulate ideas effectively in both written and oral forms
• Comfortable working independently to accomplish components of a larger program
• Strong organizational and time management skills
• Self-provided internet service must meet minimum criteria: 25 Mbps download and 10 Mbps upload.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Master’s degree
• Colon Cancer Screening (COL) measure experience
• Clinical experience

Responsibilities

• Strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics.
• Accountability for performance and operational excellence of comprehensive programs to improve Star ratings.
• Partner with multiple analytics teams to develop, prioritize, deliver, and measure solutions.
• Proactively engage the right stakeholders to anticipate headwinds and identify gaps, looking ahead to anticipate pivots and action needed.
• Make recommendations based on reporting and monitoring by contract, region, provider and aggregate performance, identifying where things are going well and why, and where things need to improve and how.
• Cross-collaboration with performance management team to interpret and deliver key recommendations to achieve Stars goals.
• Conduct audits of all data collection and processes to ensure operational excellence across initiatives.
• Create standard operating procedures, document data collection, and establish processes for audit and quality control.
• Identify gaps and new opportunities to improve performance.
• Support key functions with strategic and analytical thinking.
• Provide insights for new concepts, technologies or processes.
• Provide insights to improve performance in key contracts and regions.
• Identify new opportunities to impact.

Benefits

• Medical benefits
• Dental benefits
• 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 disability
• Long-term disability
• Life insurance
• Bonus incentive plan

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree