VP, Enterprise Medicare Stars and Strategy (Finance)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Vice President, Enterprise Stars will lead the national strategy & execution to improve and sustain Medicare Advantage Star Ratings across all markets. This role is responsible for building an enterprise-wide Stars performance infrastructure, including CAHPS, HEDIS, HOS, and administrative measures. The ideal candidate brings a deep understanding of CMS methodologies, a proven track record of provider and market engagement, and a data-first approach to quality improvement.
This leader will also support the enterprise-wide Social Determinants of Health (SDOH) strategy, initiatives, and reporting tied to Stars, and will be responsible for identifying, hiring, and developing high-performing talent to ensure long-term leadership and succession planning.

Key Responsibilities

1. Enterprise Strategy & Execution

• Define and lead the strategic roadmap for Stars performance across the organization
• Ensure alignment of Stars strategy with growth, compliance, and operational goals with the aim for 5 Stars
• Integrate Stars workstreams across clinical operations, network, finance, pharmacy, member experience, and product

2. CMS Forecasting & Regulatory Insight

• Maintain expertise in CMS Star Ratings methodology, cut-point trends, measure changes, and weighting
• Lead forecasting and simulation models to anticipate performance shifts and regulatory impacts
• Translate CMS policy direction into tactical execution plans at the enterprise and market levels

3. Provider & Market Alignment

• Design and deploy Stars improvement strategies tailored to specific markets and provider groups
• Implement scorecards, incentive models, and training aligned with CAHPS and HEDIS measures
• Work closely with medical management, network, and market leads to embed Stars in provider performance management

4. Campaign Management & Gap Closure

• Lead targeted campaigns focused on closing gaps in care and improving member experience
• Operationalize objective key results with field, admin and clinical teams for CAHPS, HEDIS, and HOS measures
• Monitor execution with clear accountability frameworks and weekly dashboards

5. Data & Performance Analytics

• Partner with data science, actuarial, and analytics teams to design predictive and performance models
• Monitor progress against key Stars metrics and market-specific goals
• Present insights and recommendations to executive leadership and board-level stakeholders

6. Talent Management & SDOH Strategy

• Support the enterprise-wide Social Determinants of Health (SDOH) strategy, initiatives, and reporting tied to STARS
• Identify, hire, and train staff members, developing them into strong leaders and creating high-performing, self-directed teams
• Lead enterprise succession planning efforts to ensure a strong talent pipeline aligned with future business needs

Qualifications

Required:

• 10+ years in Medicare Advantage with a focus on Stars, quality improvement, or regulatory performance
• In-depth knowledge of CMS Stars methodology and proven success improving CAHPS and HEDIS scores
• Strong leadership in cross-functional environments and provider engagement
• Analytical thinker with experience using data to drive strategy, forecasting, and execution
• Bachelor's degree required;

Preferred:

MPH, MBA, or related advanced degree
Pay Range: $198,219.00 - $297,329.00

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

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