Principal for Stars Care Coordination, Provider Strategy

Become a part of our caring community We are looking for a dynamic Strategy Execution/Advancement Principal for Care Coordination to develop clinical solutions for our members and providers, with full accountability from strategy to execution.The Principal for Stars Care Coordination, Provider Strategy is responsible for developing, executing, and optimizing strategies that engage hospital systems and provider groups to improve performance on key Stars Care Coordination measures. The role will design and implement financial incentive programs targeted at reducing Plan All-Cause Readmission rates and enhancing provider performance on metrics such as Post-Discharge Physician Visit Rate (PCR), Follow-Up after Mental Health Hospitalization (FMC), and Timely Receipt of Care (TRC). Additionally, the incumbent will support performance management initiatives to drive measurable improvements across both hospitals and provider networks.Key Responsibilities:Lead the design, implementation, and evaluation of financial incentive programs for hospital systems to reduce Plan All-Cause Readmission rates.Develop and manage incentive structures for providers to improve performance on PCR, FMC, and TRC metrics.Partner with internal and external stakeholders to ensure alignment of incentive programs with organizational goals and compliance requirements.Provide guidance and support to hospitals and providers in understanding Stars Care Coordination measures and best practices for performance improvement.Monitor, analyze, and report on the effectiveness of financial incentive programs and overall provider performance against Stars metrics.Support the development and execution of performance management strategies for both hospitals and providers, including performance tracking, feedback, and intervention.Collaborate cross-functionally with clinical, operational, and analytics teams to ensure coordinated efforts toward Stars rating improvement.Stay current with industry trends, CMS guidelines, and best practices related to Stars Care Coordination and value-based incentive programs. Use your skills to make an impact Role EssentialsBachelor’s degree2-3+ years of full-time strategy consulting experience with a leading management consulting firm, and/or strategy consulting experience outside of a consulting firm (e.g., healthcare organization); 5-7+ years of total work experience requiring consulting related skills/capabilities2 - 5 years or more of project/people leadership experienceExperience working directly with provider groups, clinical leaders, and/or care teamsStrong data literacy with demonstrated experience using analytics to drive operational insightsExcellent communication, relationship-building, and cross-functional collaboration skillsAbility to independently manage complex initiatives, work across departments, and drive execution without day-to-day oversightRole DesirablesExperience with value-based contracting and/or provider incentive programsAdditional InformationTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours40Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$166,700 - $2