Director Stars HEDIS Improvement and Operations

Profile

Description

Description: The Director, Stars HEDIS Improvement and Operations, leads the advancement of the initiative improvement strategy, operational execution and performance oversight in effort to maintain Humana's strong HEDIS Stars results. This individual will lead the team in defining improvement objectives focused on clinical gap closure, health outcomes and improved member experience. In addition, will lead a team equipped to ensure operational readiness across internal and external partners, define and connect end- to- end operational processes, and develop holistic reporting dashboards to better enable performance monitoring. This leader will be responsible for identifying and resolving complex technical and operational problems impacting member engagement and Stars gap in care performance outcomes.

Responsibilities

The Director, Stars HEDIS Improvement and Operations, leads the advancement of the initiative improvement strategy, operational execution and performance oversight in effort to maintain Humana's strong HEDIS Stars results. This individual will lead the team in defining improvement objectives focused on clinical gap closure, health outcomes and improved member experience. In addition, will lead a team equipped to ensure operational readiness across internal and external partners, define and connect end- to- end operational processes, and develop holistic reporting dashboards to better enable performance monitoring. This leader will be responsible for identifying and resolving complex technical and operational problems impacting member engagement and Stars gap in care performance outcomes.

Role responsibilities:

Acquire deep technical understanding of HEDIS Stars measures and serve as organization SME

Develop and maintain portfolio of HEDIS program improvement initiatives focused on delivering improved performance rates and optimal customer experiences

Conduct test and learn initiatives to prove capabilities and determine effectiveness of solutions

Create collaborative working relationships with partners across the organization in effort to create shared learning agendas and goals

Oversee the HEDIS Stars Operations budget, vendor relationships and project/ program management

Lead and develop team of high- performing direct reports

Oversee performance oversight and roadmap toward operational excellence for Stars HEDIS operational areas including: Test Kit Program operations, Stars Outreach team, and HEDIS process improvement and portfolio management

Ability to ascertain diverse and complex initiative level issues and barriers across process level metrics; must be able to take complex problems and distill into manageable pieces to develop solutions

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

Role essentials:

Bachelor's Degree or 5 years equivalent

2-5 years of management experience

Medicare Stars experience or HEDIS experience

Previous operational leadership experience

Proven skills in analyzing data trends and identifying performance improvement opportunities

Strong attention to detail and focus on customer experience and quality

Excellent communication skills

Ability to operate under tight deadlines

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

Must be passionate about contributing to an organization focused on continuously improving consumer experiences and health outcomes

Preferred Qualifications:

Master's degree

PMP certification

Six Sigma Certification

Additional Information

Location preference is Office base in Louisville, willing to consider out of state work from home.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com