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

Humana is a $100 billion (Fortune 42) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana is committed to advancing the employment experience and vitality of the associate community. Through offerings anchored in a whole-person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive.

Against that backdrop, we are seeking a talented and experienced leader for the Vice President, Stars position within the Healthcare Quality, Reporting and Improvement (HQRI) organization. This role is responsible for overseeing and optimizing the CMS Stars Program at Humana to drive quality outcomes, improve member satisfaction and maximize performance in the Medicare Advantage space.

The CMS Stars Rating Program is a critical component of our organization’s success as it directly impacts our ability to attract and retain members, as well as our reimbursement rates from CMS. The VP, Stars creates and owns the vision, mission, and strategic plan for the Stars program for the enterprise which is a key strategic priority for Humana. This critical role is responsible for all aspects of our Stars program including achieving and sustaining industry leading Stars results reflecting the high quality of care provided to members and patients and allowing Humana to maintain our competitive advantage. This role will impact our overall Medicare and Medicaid strategy, as it directly impacts the revenue needed to fund benefits.

The VP will report directly to the SVP, Stars, Trend and Clinical Analytics and lead a multi-level organization of more than 100 associates, with approximately 5 direct reports. This position can be located anywhere within the contiguous United States, although there is a preference for Humana’s headquarters in Louisville where a majority of the team is located. Moderate travel (~20%) should be expected.

Key Responsibilities:

• Create and own the vision, mission, and strategic plan for Stars for the enterprise. Lead Humana’s Stars program which rewards quality and is responsible for material annual revenue.
• Responsible for all aspects of the Stars program at Humana including achieving and sustaining industry leading Stars results reflecting the high quality of care provided to members and patients and allowing Humana to maintain our competitive advantage.
• Works across and beyond the enterprise to drive performance improvement on 40 measures of health outcomes, customer experience and plan administration.
• Accountable for monitoring and analyzing performance data to identify areas for improvement and implement action plans to address gaps.
• Builds relationships with key stakeholders, including healthcare providers, regulatory agencies, and internal teams to drive program success.
• Serves as a key contact on Stars for internal partners and informs the Management Team and Board of Directors on priorities related to Stars.
• Represents Humana as an industry leader in quality improvement and CMS Stars Ratings, staying ahead of trends and best practices and focuses on influencing quality measures and performance improvement, both internally and externally
• Stays current on CMS guidelines and regulations related to quality measures and Stars Ratings ensuring compliance and alignment with best practices.
• Develops strategies to ensure readiness for anticipated Stars changes for new measures.
• Provides leadership to a team of professionals and the Stars organization of approximately 100 associates responsible for the execution of the CMS Stars program

Use your skills to make an impact

Required Qualifications

• Bachelor’s degree in healthcare administration, business, or a related field. Master’s degree is highly desired.
• Extensive experience with CMS guidelines, CMS Stars Rating Program, and compliance.
• 10 plus years leadership experience in the healthcare industry, preferably with the Stars Program, with a proven track record of driving quality, financial and operational performance
• Deep knowledge of the health insurance industry, competitive landscape, and Medicare operations end-to-end
• In-depth understanding of partners/functions within and outside the segment. Understanding of how organization capabilities interrelate across segments and enterprise wide.
• Demonstrated ability in building strategic relationships with internal and external parties, including cross-functional partners, corporate and market functions, and providers.
• Proven ability to manage the complexity of competing priorities.
• Ability to understand and leverage data analytics for forecasting, performance improvement, and decision-making
• Excellent oral and written communications skills, including the polish, poise, and executive presence that will ensure effective interaction with senior and executive level audiences, both internally and externally.
• Current or recent experience in a large, highly matrixed company (i.e., Fortune 150), with proven ability to influence leaders and key stakeholders, develop and execute enterprise strategy, and achieve successful outcomes in such an environment.
• Highly collaborative mindset and excellent relationship-building skills, including the ability to engage many diverse stakeholders and SMEs and win their co-ownership in the outcome, particularly in scenarios that call for “tough conversations” to be conducted.
• Strong leader of people with proven success in expanding and elevating the capabilities and performance of a multi-level team and large-scale organization

Additional Information

• Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website.
• Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
  
  Health benefits effective day 1
  Paid time off, holidays, volunteer time and jury duty pay
  Recognition pay
  401(k) retirement savings plan with employer match
  Tuition assistance
  Scholarships for eligible dependents
  Parental and caregiver leave
  Employee charity matching program
  Network Resource Groups (NRGs)
  Career development opportunities

Scheduled Weekly Hours

40

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.