VP, Medicare Stars Programs

Morgan Consulting Resources, Inc. has been retained to conduct the search for the Vice President, Medicare Stars Programs for Inland Empire Health Plan .

The role is based in Rancho Cucamonga, CA. A hybrid schedule is available allowing for three days in the office and two days working remotely.

Want to apply Read all the information about this position below, then hit the apply button.

About the Organization :

With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid plan in the country.

In its 26th year, IEHP supports nearly 1.6 million members who are enrolled in Medicaid and has a growing network of over 7,800 providers and nearly 4,000 Team Members (Employees).

Through dynamic partnerships, award-winning service, and a tradition of quality care, IEHP is fully committed to its Mission, Vision, and Values.

For details regarding IEHP, please visit : iehp.org.

About the Position :

The Vice President of Medicare Stars Programs is responsible for health plan strategy and achieving IEHP’s performance goals for the Part C and D Medicare Stars programs for all Medicare products (e.

g., D-SNP, MA-PD, etc.). This proven leader will devise and implement Medicare Stars strategies across the organization to achieve continuous improvements in the Plan’s CMS Star Ratings measures, aiming for at least 4 stars consistently.

The role involves developing effective relationships with key stakeholders and the Provider Network, collaborating with business units like the Provider Network and Health Services team to ensure optimal Star Ratings.

The ideal candidate will be an accomplished healthcare leader with a deep understanding of Medicare Stars programs, strategic and operational expertise, and the ability to build collaborative relationships across the organization to drive continuous improvement in CMS Star Ratings.

The Vice President must thrive in a highly collaborative, mission-driven culture and have a successful track record of developing robust programs from the ground up.

Duties & Responsibilities :

• Plan, develop, and implement effective improvement strategies to achieve high performance for Medicare Part C and D Stars.
• Lead and implement Medicare Stars-related performance analytics to identify areas of opportunity, key drivers, and assess the impact on quality improvement activities.
• Partner with cross-functional business units to plan and execute Stars improvement strategies and programs, including new initiatives, managing existing projects, evaluating and optimizing programs, and ensuring compliance.
• Develop strategic direction, training, goals, and coaching plans for the Medicare Stars Team and cross-functional IEHP Teams supporting Stars programs.
• Lead cross-functional teams to implement Medicare Stars measure-level improvement interventions and partner with internal and external resources.
• Build strong relationships with the IEHP Provider Network to communicate new requirements and opportunities around clinical workflow, data reporting, and support services to optimize quality outcomes, including IEHP Pay for Performance results.
• Influence thought leadership regarding measure-level improvement opportunities and serve as a subject matter expert in meetings and discussions.
• Collaborate with cross-functional teams to track Stars program KPIs, inform timely follow-up, escalate gaps and barriers, and advance innovative workflows to support quality improvement initiatives.

Experience Requirements :

• Minimum of ten (10) years of progressive, operational experience in a health plan or managed care setting with a focus on excellent process and execution.
• Proven experience in driving and leading at least a 4 Star Medicare or Medicare Advantage Stars Rating, with specific rollout and implementation experience in achieving at least a 4 Star rating in a non-integrated healthcare setting.
• Five (5) years of senior-level leadership / management experience is required.

Education :

• Bachelor’s degree in a related field from an accredited institution required.
• Master’s degree or higher in healthcare administration, nursing, hospital administration, business, public health, or a related field from an accredited institution preferred.

Salary range : A reasonable starting salary expectation is between $246,355 and $344,905, based upon related / relevant experience and internal equity.

Meaningful Interest Points About Rancho Cucamonga :

Rancho Cucamonga offers all the amenities and qualities that make for a family-friendly city. The public schools in the city are performing slightly above the national average.

In fact, the average test score here is 2% higher than the national average and the student-teacher ratio is 23 : 1. And in 2018, this city was part of the happiest towns to live in the United States.

This is a result of its wellbeing, community and environment, and income and employment. The city continues to excel over the years.

For example, in 2020, the national civic league named it one of the Ten All-America cities due to its efforts and improvements in healthcare and wellbeing.

The town’s central location is a major perk, providing easy access to San Diego (less than two hours), Palm Springs (just over an hour), and Los Angeles (only 45 minutes by car).

It is also conveniently close to both beaches and mountains.

If you or someone you know meets the qualifications for this role, I would be delighted to arrange a conversation. Thank you for your time and consideration.

Lisa Coyne, Principal

Morgan Consulting Resources, Inc.

[email protected]

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