Health Care Service Corporation
Executive Director, Stars Strategy
Health Care Service Corporation, Chicago, Illinois, United States, 60601
Executive Director Of Star Strategy
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary
The Executive Director of STAR Strategy plays a pivotal role in advancing the quality performance and operational excellence of a Medicare Advantage organization. This senior leader is responsible for developing, executing, and overseeing enterprise-wide strategies aimed at achieving and sustaining high STAR Ratingsan essential driver of plan reputation, member retention, and market competitiveness. This role is critical to the financial health and growth of the Medicare Advantage line of business. High STAR Ratings directly translate into increased quality bonus payments, expanded benefit enhancement opportunities. The Executive Director ensures the organization remains competitive in a rapidly evolving landscape by maintaining a relentless focus on quality, innovation, and member outcomes. Job Responsibilities: Support senior leadership in developing and executing on strategic and reporting roadmap for Stars organization Perform analysis of HCSC performance for aligned Stars measures, gap identification, and gap remediation strategies and initiatives across measures Ensure remediation and implementation of any CMS guidance or regulatory changes Manage governance and oversight activities for aligned Star measure categories, establish and maintaining a regular cadence of touchpoints with key internal and external stakeholders across the enterprise to share progress against target performance and rating goals, and identify / address issues and escalations Manage a team of SME resources aligned to key Star domains and responsible for overseeing performance of key business stakeholders on activities related to Star measures and initiatives, root cause analysis for performance gaps, and developing and managing the execution of gap remediation strategies for their areas of expertise Strategic Leadership: Design and lead cross-functional initiatives to improve STAR performance across clinical, operational, pharmacy, customer service, and member engagement domains. Data-Driven Management: Use advanced analytics to identify performance gaps, track KPIs, and prioritize interventions that yield the highest impact on CMS STAR measures. Collaboration & Integration: Partner with departments such as Quality, Population Health, Risk Adjustment, IT, and Provider Relations to align STAR initiatives with broader organizational goals and value-based care models. Regulatory Insight: Ensure full compliance with CMS guidelines and anticipate regulatory changes that may affect STAR Ratings. Translate policy shifts into actionable business plans. Member-Centric Focus: Lead initiatives to improve member experience, access to care, medication adherence, and preventive servicesall of which directly affect STAR Ratings. Required Job Qualifications: Bachelor Degree OR 9 years of experience in the health care industry 5 years of Group Medicare experience 3 years in implementation (pre and post) Experience in customer/member experience Experience with strategic planning, strategy development, project management and/or analytics and research *Please note, this is a hybrid role in the assigned office 3 days/week HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $158,300.00 - $293,800.00
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary
The Executive Director of STAR Strategy plays a pivotal role in advancing the quality performance and operational excellence of a Medicare Advantage organization. This senior leader is responsible for developing, executing, and overseeing enterprise-wide strategies aimed at achieving and sustaining high STAR Ratingsan essential driver of plan reputation, member retention, and market competitiveness. This role is critical to the financial health and growth of the Medicare Advantage line of business. High STAR Ratings directly translate into increased quality bonus payments, expanded benefit enhancement opportunities. The Executive Director ensures the organization remains competitive in a rapidly evolving landscape by maintaining a relentless focus on quality, innovation, and member outcomes. Job Responsibilities: Support senior leadership in developing and executing on strategic and reporting roadmap for Stars organization Perform analysis of HCSC performance for aligned Stars measures, gap identification, and gap remediation strategies and initiatives across measures Ensure remediation and implementation of any CMS guidance or regulatory changes Manage governance and oversight activities for aligned Star measure categories, establish and maintaining a regular cadence of touchpoints with key internal and external stakeholders across the enterprise to share progress against target performance and rating goals, and identify / address issues and escalations Manage a team of SME resources aligned to key Star domains and responsible for overseeing performance of key business stakeholders on activities related to Star measures and initiatives, root cause analysis for performance gaps, and developing and managing the execution of gap remediation strategies for their areas of expertise Strategic Leadership: Design and lead cross-functional initiatives to improve STAR performance across clinical, operational, pharmacy, customer service, and member engagement domains. Data-Driven Management: Use advanced analytics to identify performance gaps, track KPIs, and prioritize interventions that yield the highest impact on CMS STAR measures. Collaboration & Integration: Partner with departments such as Quality, Population Health, Risk Adjustment, IT, and Provider Relations to align STAR initiatives with broader organizational goals and value-based care models. Regulatory Insight: Ensure full compliance with CMS guidelines and anticipate regulatory changes that may affect STAR Ratings. Translate policy shifts into actionable business plans. Member-Centric Focus: Lead initiatives to improve member experience, access to care, medication adherence, and preventive servicesall of which directly affect STAR Ratings. Required Job Qualifications: Bachelor Degree OR 9 years of experience in the health care industry 5 years of Group Medicare experience 3 years in implementation (pre and post) Experience in customer/member experience Experience with strategic planning, strategy development, project management and/or analytics and research *Please note, this is a hybrid role in the assigned office 3 days/week HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $158,300.00 - $293,800.00