AVP, Stars Improvement (CAHPS/HOS)

Humana

1d • Remote

About The Position

Health Quality and Stars (HQS) is an organization that is responsible for improving health outcomes and advancing the care experience of our members and provider partners through quality solutions. 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 AVP, Stars CAHPS & HOS Improvement and Operations is responsible for overseeing the implementation, management, and continuous improvement of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) initiatives as part of the CMS Stars Program. This role will focus on enhancing member experience and satisfaction, ensuring compliance with regulatory requirements, and driving strategies to improve CAHPS and HOS scores. This highly visible position identifies actions needed to improve clinical outcomes and customer experience based on customer, market, and business needs. You will partner with and influence leaders throughout the company to deliver results.

Requirements

• Bachelor’s Degree
• 8+ years of experience in Medicare Advantage quality, Stars and/or member experience
• Deep understanding of CAHPS/HOS survey methodology, Stars weighting, and CMS expectations
• Progressive experience in the healthcare industry, with emphasis on leading and managing teams
• Proficiency in analyzing and interpreting healthcare data and trends
• Strong attention to detail and focus on process and quality
• Ability to operate under tight deadlines
• Experience driving enterprise strategy
• Exceptional communication, collaboration, and influence skills across clinical, business, and policy audiences

Nice To Haves

• Masters degree

Responsibilities

• Serve as an internal expert on CAHPS and HOS survey methodology, regulatory changes, and CMS guidance
• Develop and execute an improvement strategy to deliver on contract, measure level targets
• Monitor results, identify trends and areas of opportunity, and drive continuous improvement
• Accelerate shared accountability for CAHPS and HOS improvement by effectively communicating the strategy to the Enterprise to create alignment, inspire action and deliver tangible results
• Develop and maintain a portfolio of improvement initiatives focused on delivering improved member experience and satisfaction, targeting key drivers of performance
• Collaborate with cross-functional teams to design, test, and scale interventions that directly impact Star ratings
• Responsible for initiative performance monitoring and development of deep, holistic operational reporting, with regular executive summary roll-up to Stars leadership
• Lead multiple analytics partners to develop robust reporting informing prioritized opportunities for Quality improvement and experience; requires ability to derive insights from large quantities of data
• Develop strategic recommendations for program evolution and policy advocacy, including written summaries and talking points for engagement with CMS, industry groups, and internal stakeholders
• Oversee budget, vendor relationships and project/ program management
• Lead and develop team of high- performing direct reports

Benefits

• Humana provides medical, dental and 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 and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Number of Employees: 5,001-10,000 employees