Cambia Health Solutions Program Director Medicare STARS in Portland, Oregon



As the Program Director, Medicare Stars, you will manage the large-scale, complex projects and multiple related initiatives in support of the Medicare Star Ratings Program, providing cross-functional program leadership. Responsible for driving tactical execution of the Star Ratings strategy and program management to ensure work stays on track, quality results are achieved, and the program continually evolves to become a comprehensive, best-in-class program.

Responsibilities & Requirements

  • Leads tactical execution of a large scale, complex Star Ratings quality improvement program in a multi- state environment.

  • Works closely with cross-functional leaders to clarify program goals and create operational plans to continuously improve our Star Ratings.

  • Provides day-to-day leadership of direct reports, cross-functional committees, and vendors. Works collaboratively with teams to plan, design, develop, implement, and manage projects.

  • Serves as a subject matter expert on trends, gaps, best practices, competitive intelligence, and effectiveness regarding Star Ratings.

  • Represents program goals and initiatives with various audiences. Cultivates and maintains relationships with key internal and external stakeholders.

  • Develops and oversees monitoring and reporting procedures to ensure deliverables and budget are on track. Communicates program status and areas of risk or opportunity.

  • Handles all management level responsibilities for direct staff, including performance reviews, employee development, hiring, coaching, counseling, and retention.

  • Partners with cross-functional leaders, provider groups, and vendors to lead organizational change.

  • Creates a sense of urgency within the organization and translates quickly evolving directions intoaction.

Minimum Requirements:

  • Expertise regarding Medicare programs with a focus on Medicare Advantage and Part D programs.

  • Proven ability to lead the design, development and implementation of process structure, tools and measurement indicators that drive operational results.

  • Demonstrated ability to lead high performing teams and to organize and support cross functional activities to deliver results in a matrix organizational structure.

  • Ability to synthesize customer and third-party feedback into operational solutions that drive ongoing enhancements to member experience within the government programs arena.

  • Demonstrated ability to think analytically, apply analytical techniques, and provide in-depth analysis and recommendations using critical thinking and sound judgment.

  • Experience with business process redesign and optimization including ability to recognize process deficiencies and recommend and implement improvements.

  • Excellent written and verbal communication skills, ability to present and facilitate and drive executive level discussions and strong customer and stakeholder management skills.

Normally to be proficient in the competencies listed above:

Program Director, Medicare Star Ratings, would have a Bachelor’sdegree in Business Administration, Healthcare Administration, or related field (Master’sdegree preferred) and 10 years of experience in Medicare operations and business process improvement, and 5 years of management/leadership experienceor equivalent combination of education and experience.

About Us

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.

Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.

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Requisition ID2018-24985

Category (Portal Searching)Operations