This role is responsible for supporting the Stars strategy within Insurance Operations, serving as a subject matter expert for Stars-related initiatives, and ensuring their effective activation and integration throughout the Insurance Operations organization. Insurance Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing, and customer service, each essential to delivering a comprehensive and high-quality member experience.
In this role, you will identify and engage with each area under Insurance Operations that has Stars-related initiatives to understand the business strategy, scope, and goals, building a working knowledge to inform identification and validation of potential synergies, business-specific requirements, risks, and integration paths. This role will collaborate with key Stars and segment business partners to monitor existing work, gain alignment on cross-asset integration opportunities, identify and implement new initiatives, and measure the value of the work. In addition, this role will support the inventory of existing Stars initiatives and help to identify gaps and opportunities for greater collaboration across segments. This role requires a deep understanding of operations and how it connects with enterprise Stars governance and initiatives.
Role Responsibilities:
Oversight of related budget, vendor relationships, and program/ project management
Serve as the primary liaison for Stars initiatives within Insurance Operations, building deep operational knowledge of core functional areas (care coordination, quality, billing, claims, and customer service).
Collaborate with each Insurance Operations function to identify, understand, and align Stars-related business strategies, objectives, and operational requirements.
Evaluate business processes across Insurance Operations to identify synergies, integration opportunities, and operational risks related to Stars performance and compliance.
Coordinate with analytics and reporting teams to generate actionable insights, enabling data-driven prioritization of operational improvements that directly impact Stars measures.
Partner with segment and enterprise Stars leaders to advance cross-functional initiatives, ensuring alignment between operational execution and Stars strategy.
Maintain a comprehensive inventory of Stars initiatives within Insurance Operations, identifying gaps and facilitating collaboration to maximize impact across all operational areas.
Lead and support the design, implementation, and optimization of Stars-related programs and processes within Insurance Operations, including performance monitoring and continuous improvement.
Oversee test-and-learn pilots to validate solutions and measure operational effectiveness, using results to inform broader implementation.
Develop and deliver regular reports on Stars operational performance to executive leadership, providing clear visibility into progress, challenges, and opportunities.
Manage budgets, vendor relationships, and project plans to support the successful delivery of Stars-focused operational initiatives.
Required Qualifications
Bachelor’s degree
8-9 + years of quality improvement, developing & advancing enterprise strategy, insurance operations experience, i.e.: claims, UM, CM, call center, enrollment, etc.
5 years or more of CMS Stars program experience
Medicare Advantage experience
Previous leadership experience as a people leader, leading through influence, or leading complex projects with engagement from multiple areas of the company
Demonstrated track record of ability to tell the story, influence leaders and drive improvement activity in a matrixed organization
Strong executive presence
Ability to navigate business intelligence tools to review data insights & making data driven decisions
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
Preferred Qualifications
Master’s Degree
Additional Information
To 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 recommended; 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 Hours
40Pay Range
The 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.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 12-18-2025
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.