D-SNP Stars & Clinical Principal Remote Nationwide

Position Overview

Become a part of our caring community and help us put health first. Be part of Medicaid’s D-SNP Center of Excellence. In this role, you will support Quality and Stars initiatives within Medicaid DSNP markets and serve as a subject matter expert, ensuring effective activation and integration within the Insurance Operations organization. You will drive quality outcomes and access by identifying synergies, managing key enterprise relationships, and scaling best practices across integrated states.

Key Responsibilities

• Oversight of related budget, vendor relationships, and program/project management.
• Serve as the primary liaison for Stars initiatives within Medicaid D-SNP, building deep operational knowledge across care coordination, quality, billing, claims, and customer service.
• Support the prioritization and resolution of market issues by collaborating with both Medicare and Medicaid teams, including centralized services.
• Act as the primary business partner with the Medicare Stars organization to align Stars-related business strategies and operational requirements, directly enhancing member experience.
• Enhance and align data sharing processes between Medicare and Medicaid while evaluating business processes to identify synergies, integration opportunities, and risks.
• Scale best practices and create standardization opportunities across integrated states.
• Coordinate with analytics and reporting teams to generate actionable insights for data-driven operational improvements impacting Stars measures.
• Advance integrated care-team approaches across Medicare and Medicaid segments.
• Partner with enterprise Stars leaders to drive cross-functional initiatives ensuring alignment between execution and Stars strategy.
• Maintain a comprehensive inventory of Stars initiatives, identifying gaps and facilitating collaboration across operations.
• Lead and support the design, implementation, and optimization of Stars-related programs including performance monitoring and continuous improvement.
• Oversee test-and-learn pilots to validate solutions and measure operational effectiveness for broader implementation.
• Develop and deliver regular reports on Stars operational performance to executive leadership.
• Manage budgets, vendor relationships, and project plans to ensure successful delivery of Stars-focused initiatives.

Required Qualifications

• Bachelor’s degree
• 5+ years of quality improvement, enterprise strategy development, and insurance operations experience (claims, UM, CM, call center, enrollment, etc.)
• 3+ years of CMS Stars program experience
• Previous leadership experience either as a people leader, through influence, or managing complex projects with cross-functional engagement
• Proven track record in storytelling, influencing leaders, and driving improvement in a matrixed organization
• Strong executive presence
• Ability to utilize business intelligence tools to analyze data and make data-driven decisions
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and PowerPoint

Preferred Qualifications

• D-SNP experience
• Medicaid and MLTSS experience

Benefits & Perks

• Compensation: $138,900 - $191,000 per year plus eligibility for a bonus incentive plan
• Benefits: Competitive medical, dental, and vision benefits; a 401(k) retirement savings plan; paid time off, holidays, and parental/caregiver leave; short-term and long-term disability; and life insurance.
• Remote work available with preferred locations in KY, FL, IL, WI, IN, VA, and MI