Director, Star Ratings & Quality Programs

Summary

Join Honest Health as the Director, Star Ratings & Quality Programs, leading the strategy for clinical excellence across our provider network and payer contracts. Collaborate with partner organizations and Honest Health market teams to craft and execute strategies that elevate patient care and ensure compliance. Translate complex requirements into actionable plans, offering expert guidance to teams. Provide visionary leadership to the Clinical Quality Team, fostering a collaborative culture that drives continuous improvement. Actively engage and guide team members to deliver exceptional patient care, shaping educational resources and integrating quality-focused learning. Reinforce Honest Health’s commitment to excellence and measurable impact in primary care. This is a key role driving clinical excellence and ensuring compliance with Medicare Advantage, ACO REACH, and other quality metrics.

Requirements

• Bachelor's degree in healthcare administration or similar field required
• 7+ years of experience working in health care quality
• 3+ years experience with Star Ratings, HEDIS, and ACO REACH quality
• 3+ years of experience leading teams and developing talent
• Demonstrable working knowledge of and experience with Electronic Health Records (EHRs)
• Occasional travel to Nashville or clients, as needed
• Proficiency with Excel, Word, PowerPoint and Adobe PDFs

Responsibilities

• Provide dynamic leadership to the Quality Team, fostering a culture of engagement, accountability, and collaboration to consistently achieve and exceed quality and performance targets across the organization
• Design, develop, and execute comprehensive quality work plans tailored to the needs of diverse provider partners, ensuring measurable improvements in Star Ratings, ACO REACH, and other quality program metrics as well as the achievement of practice-specific quality goals
• Act as the primary subject matter expert on quality programs, advocating for a quality-driven mindset throughout Honest Health and serving as a resource for internal teams, practice partners, and external stakeholders
• Interpret, explain, and operationalize complex regulatory guidelines and quality standards from CMS, NCQA, and other governing bodies, supporting the continuous enhancement of quality programs, product offerings, and strategic work plans
• Collaborate closely with internal Care Management and Clinical Documentation Improvement (CDI) teams to align strategies and processes, optimize vendor relationships, and ensure effective chart review and data integrity workflows
• Undertake additional responsibilities as needed, proactively addressing emerging challenges and contributing to organizational initiatives that support Honest Health’s mission and values

Preferred Qualifications

• Experience with risk adjustment preferred
• Data analytics experience preferred

Benefits

• Competitive Compensation
• Attractive base salary with performance-based bonuses and rewards
• 401(k) plan with a generous company match, fully vested from day one
• Comprehensive Health and Wellness Benefits
• Flexible health, dental, and vision insurance options tailored to your needs
• Company contribution towards health savings accounts (HSA) for high-deductible health plan (HDHP) participants
• 100% company-paid short-term disability, long-term disability, and life insurance
• Wellness programs and resources to support your physical and mental health
• Generous paid time off, including vacation, sick leave, and 11 paid holidays annually
• Two paid volunteer days to support causes you're passionate about
• Flexible work arrangements to accommodate your lifestyle
• Robust onboarding program and ongoing training opportunities
• Reimbursement for role-related continuing education and certifications
• Paid parental leave for new parents
• Dependent care flexible spending accounts
• Support for work-life integration
• Team member recognition programs
• Team-building events and social activities