Medicare STARS Director
Intermountain Health, Murray, UT, United States
Job Description: This leader provides strategic and operational leadership for the organization’s Medicare Advantage Star Ratings program. This role is accountable for the development, execution, and continuous improvement of initiatives that drive performance across all CMS Star measures, including clinical quality, pharmacy, member experience, and operational metrics. The leader partners across clinical, operational, analytic, and compliance functions to ensure alignment with CMS requirements, sustained quality improvement, and achievement of targeted Star Ratings performance.
This position can be performed remotely with business travel as-needed. Intermountain and Select Health maintain employment registration in Utah, Idaho, Nevada, Colorado, and Montana. Candidates in other locations may be considered. Currently, we are not hiring remote workers in the following states: CA, CT, HI, IL, NY, RI, VT, and WA. Please note that a video interview through Microsoft Teams will be required as well as onsite interviews and/or meetings.
Essential Functions
Develops and implement a multi-year Medicare STARS strategy aligned with organizational goals and financial performance.
Leads the STARS workplan, including prioritization of measures, intervention design, timelines, and performance targets.
Serves as the accountable owner for performance across all CMS Star measures, including HEDIS, CAHPS, Part D, and operational metrics.
Establishes and leads STARS governance structures, including executive steering committees and cross‑functional workgroups.
Monitors and manages to CMS regulatory guidance, Technical Notes, and cut‑point trends; translating those requirements into operational and clinical action plans.
Oversees performance monitoring, forecasting, and reporting, including leading indicators and risk identification.
Partners with Analytics, Clinical Operations, Pharmacy, Provider Relations, Member Experience, Compliance, and Finance teams to drive measurable improvement.
Manages relationships with external vendors supporting STARS performance, including HEDIS, CAHPS, pharmacy analytics, MTM, and member experience partners.
Communicates performance results, risks, and opportunities to senior leadership in a clear and actionable manner.
Skills
Strategic Planning
Analytical skills
Presentation
Written and verbal communication
Leadership
Data management
Budgeting
Operations management
Customer satisfaction
Member engagement
Regulatory compliance
Minimum Qualifications
Ten (10) or more years of progressive experience in Medicare Advantage, managed care, or highly regulated healthcare environments.
Seven (7) or more years of direct leadership responsibility for Medicare STARS, quality improvement, HEDIS, CAHPS, Part D, or enterprise performance management.
Demonstrated success leading Star Ratings improvement or recovery efforts in complex or underperforming environments.
Proven track record of improving or sustaining 4‑Star or higher performance, or leading material performance recovery efforts.
Experience managing enterprise vendor portfolios, including HEDIS, CAHPS, pharmacy analytics, MTM, and member experience platforms, with clear performance accountability.
Direct experience supporting CMS audits, data validations, corrective action plans, and regulatory inquiries related to Star Ratings.
Experience influencing senior executives, Boards, providers, and cross‑functional leaders to achieve measurable performance outcomes.
Strong analytical orientation with experience leveraging data to inform strategy, investment decisions, and operational execution.
Exceptional executive communication, presentation, and stakeholder‑management skills.
Preferred Qualifications
Experience in a provider‑sponsored health plan, integrated delivery system, or value‑based care environment, with strong provider partnership models.
Experience leading large‑scale change management initiatives impacting clinical, operational, and member‑facing workflows.
Additional Information
This is an exempt, full‑time position. Pay offers are determined by prior years of relevant experience within the established pay range. In addition to the annual salary, to show our commitment to you and assist with your transition, we may offer a sign‑on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P award opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Board‑approved goals.
Location SelectHealth - Broomfield, SelectHealth - Idaho, SelectHealth - Murray, SelectHealth - Nevada
Work City Murray
Work State Utah
Scheduled Weekly Hours 40
Hourly Rate $77.50 - $119.68
Benefits We care about your well‑being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Equal Opportunity Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Notice All positions subject to close without notice.
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This position can be performed remotely with business travel as-needed. Intermountain and Select Health maintain employment registration in Utah, Idaho, Nevada, Colorado, and Montana. Candidates in other locations may be considered. Currently, we are not hiring remote workers in the following states: CA, CT, HI, IL, NY, RI, VT, and WA. Please note that a video interview through Microsoft Teams will be required as well as onsite interviews and/or meetings.
Essential Functions
Develops and implement a multi-year Medicare STARS strategy aligned with organizational goals and financial performance.
Leads the STARS workplan, including prioritization of measures, intervention design, timelines, and performance targets.
Serves as the accountable owner for performance across all CMS Star measures, including HEDIS, CAHPS, Part D, and operational metrics.
Establishes and leads STARS governance structures, including executive steering committees and cross‑functional workgroups.
Monitors and manages to CMS regulatory guidance, Technical Notes, and cut‑point trends; translating those requirements into operational and clinical action plans.
Oversees performance monitoring, forecasting, and reporting, including leading indicators and risk identification.
Partners with Analytics, Clinical Operations, Pharmacy, Provider Relations, Member Experience, Compliance, and Finance teams to drive measurable improvement.
Manages relationships with external vendors supporting STARS performance, including HEDIS, CAHPS, pharmacy analytics, MTM, and member experience partners.
Communicates performance results, risks, and opportunities to senior leadership in a clear and actionable manner.
Skills
Strategic Planning
Analytical skills
Presentation
Written and verbal communication
Leadership
Data management
Budgeting
Operations management
Customer satisfaction
Member engagement
Regulatory compliance
Minimum Qualifications
Ten (10) or more years of progressive experience in Medicare Advantage, managed care, or highly regulated healthcare environments.
Seven (7) or more years of direct leadership responsibility for Medicare STARS, quality improvement, HEDIS, CAHPS, Part D, or enterprise performance management.
Demonstrated success leading Star Ratings improvement or recovery efforts in complex or underperforming environments.
Proven track record of improving or sustaining 4‑Star or higher performance, or leading material performance recovery efforts.
Experience managing enterprise vendor portfolios, including HEDIS, CAHPS, pharmacy analytics, MTM, and member experience platforms, with clear performance accountability.
Direct experience supporting CMS audits, data validations, corrective action plans, and regulatory inquiries related to Star Ratings.
Experience influencing senior executives, Boards, providers, and cross‑functional leaders to achieve measurable performance outcomes.
Strong analytical orientation with experience leveraging data to inform strategy, investment decisions, and operational execution.
Exceptional executive communication, presentation, and stakeholder‑management skills.
Preferred Qualifications
Experience in a provider‑sponsored health plan, integrated delivery system, or value‑based care environment, with strong provider partnership models.
Experience leading large‑scale change management initiatives impacting clinical, operational, and member‑facing workflows.
Additional Information
This is an exempt, full‑time position. Pay offers are determined by prior years of relevant experience within the established pay range. In addition to the annual salary, to show our commitment to you and assist with your transition, we may offer a sign‑on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P award opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Board‑approved goals.
Location SelectHealth - Broomfield, SelectHealth - Idaho, SelectHealth - Murray, SelectHealth - Nevada
Work City Murray
Work State Utah
Scheduled Weekly Hours 40
Hourly Rate $77.50 - $119.68
Benefits We care about your well‑being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Equal Opportunity Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Notice All positions subject to close without notice.
#J-18808-Ljbffr