The VP, Medicare Stars will be a key member of Aledade’s Payer Strategy and Engagement team and will be responsible for understanding, aligning, and integrating health plan strategies with Aledade’s operating model to ensure success in Medicare Star ratings performance
Primary Duties:
- Stakeholder Engagement & Representation
- Build and sustain relationships with health plan leaders focused on Star quality measure success
- Ensure deep understanding of health plan goals and strategies, able to balance macro trends and granular insights
- Lead health plan meetings with over 10 partners to discuss Aledade’s Star performance and shared priorities with health plan partners; consistently presenting Aledade’s unique advantages and opportunities
- Execute on mutual goals including and not limited to clinical and operational strategies, data availability, programs, and incentives
- Partner with Aledade Clinical leadership to represent our comprehensive Star strategy to external partners
- Partner with Aledade Health Plan Performance team to engage and align field teams’ practice performance activities on key strategies
- Partner with Aledade Policy team to understand CMS Star measure ratings’ policies and regulations; follow industry ecosystem and trends
- Quality Performance & Strategy
- Share and align health plan perspectives and strategies with cross-functional leaders including Aledade clinical and product owners
- Identify and troubleshoot potential areas of misalignment
Minimum Qualifications:
- Bachelor’s Degree
- 15+ yrs’ in healthcare ideally in healthcare strategy. Plus 8-10 yrs’ in a senior level role.
- 7+ yrs’ in Medicare Stars performance and/or value-based care and “provider enablement”
- Strong knowledge of current CMS policies governing Medicare Stars Ratings performance
- Data-driven with the ability to synthesize data from multiple sources to inform action plans and strategy and make sound decisions; Root cause/corrective action expertise.
- Strong executive presence, communication, and presentation skills
- Ability to get results by successfully navigating key stakeholder relationships (Internal & external) at all levels in a highly collaborative environment
- Strong focus on tech enablement to improve scalability and reduce operating costs.
Preferred Qualifications:
- Master’s degree in business, health administration, and/or public policy
- Clinical experience (i.e. RN, APRN, PA, MD, DO) preferably in the primary care setting
- Knowledge and/or experience in performing internal and external quality audits
- Prior experience in a provider setting (i.e. value-based care enabler) or a health plan setting
- Experience with Google Suite
- Familiarity with Electronic Health Record (EHR) systems
Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer
- This role requires up to 20% travel