Principal, Stars Growth Strategy

Overview

Become a part of our caring community and help us put health first

The Principal, Stars Contract Growth Strategy develops, implements, and manages oversight of the company's growth strategy and its impact to the Stars Program. The Stars Improvement Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.

HQRI is an organization that is responsible for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and quality (Stars) solutions that leverage data and technology to empower members, providers, and Humana. HQRI Health Quality and Stars (HQS) is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS).

The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.

The Principal, Stars Contract Growth Strategy, will lead the development and acceleration of a comprehensive Medicare Advantage (MA) contract offering and membership growth strategy that will sustain Humana as an industry leader in Stars performance and new member acquisition. This highly visible position will lead a cross-functional workgroup in defining and prioritizing a strategic plan for Humana’s current and future products.

This leader has a passion for delivering quality in healthcare and an in-depth understanding of how enterprise functions interrelate, serving as an advanced subject matter expert. This leader is able to partner with and influence leaders throughout the company on this complex work in order to create shared accountability for strategic advancement and Stars performance.

Role responsibilities:

• Develop, own and manage the Stars enterprise contract growth strategy and effectively communicate the strategy across the enterprise to create alignment, inspire action and deliver tangible results

• Lead and influence key enterprise stakeholders, including Market Leadership, Product Compliance, and Benefit Design to consensus on contract strategy and which growth mechanisms to use in order to optimize Stars performance for each contract

• Analyze and understand performance and trends of geographies, contracts and sub populations of membership, and educate market leadership on these insights to influence them as they consider desired business growth, including Group membership needs

• Recommend and influence new contracts and consolidations that may be appropriate for Product Compliance to pursue in anticipation of future needs as part of the strategy

• Analyze market-driven growth mechanisms for Stars impact and make recommendations based on the defined contract growth Strategy

• Conduct market research to stay informed about the evolving Medicare landscape, market trends, and competitor strategies to inform contract growth initiatives

• Establish key performance indicators to track the success of growth strategies, making data-driven adjustments as needed

• Please note if selected candidate is local to Louisville the requirement is to be in the office a few days a week.

Use your skills to make an impact

Required Qualifications

• Bachelor’s Degree in Healthcare Administration, Business Administration or any field or equivalent experience

• 10 or more years of experience in healthcare strategy, contract management, and/or market finance roles

• 2 or more years of proven experience of cross functional leadership

• Deep understanding of Medicare regulations, reimbursement methodologies, and industry trends

• Strong analytical and data interpretation skills with the ability to translate data into actionable strategies

• Exceptional communication, presentation, and negotiation skills

• Demonstrated track record of ability to tell the story, influence leaders and drive improvement activity in a matrixed organization

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and…