Director, Clinical Quality (Medicare Stars)

Your Role

The Director of Clinical Quality - Medicare Stars reports to the Senior Director of Clinical Quality and leads the organization’s Medicare Stars HEDIS strategy, execution, and performance oversight. This role is critical to maintaining and improving Medicare Star Ratings and HEDIS performance by driving initiatives focused on clinical gap closure, quality improvement, health outcomes, and member experience.

The Director will oversee the clinical quality strategic roadmap, operational excellence, and performance oversight of multiple H-Contracts and future Medicare Advantage contracts. The position requires a dynamic leader with deep expertise in Stars, HEDIS, and quality improvement methodologies, as well as the ability to collaborate across clinical and operational functions to enhance performance outcomes and drive systemic change.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

- Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
- Master’s in Public Health (MPH), Healthcare Administration (MHA), or related field is preferred.
- 10 years of healthcare experience leading large-scale, cross-functional programs focused on quality improvement.
- 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
- 6 years of direct experience managing Stars and HEDIS performance initiatives with proven success in driving improvements.
- Strong ability to interpret complex healthcare data, develop insights, and apply analytics-driven strategies.
- Experience in Medicare Advantage quality programs, CMS requirements, and industry-leading Stars & HEDIS performance improvement techniques.
- Exceptional communication skills, with the ability to engage executive leadership, providers, and stakeholders effectively.
- Strong project management skills, with the ability to navigate tight deadlines, manage competing priorities, and lead strategic initiatives successfully.

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.