Stars Policy Lead

Become a part of our caring community and help us put health first
 Humana is seeking a Stars Policy Lead who is committed to creating an impact on healthcare quality. The Stars Policy Lead drives the regulatory advocacy strategy for Stars, positioning Humana as an industry thought leader for the future of the Stars program. This is a high-profile opportunity to join a team of subject matter experts and gain exposure to teams across the organization.

The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations. This role will support overall portfolio management of the Stars organization through research, critical thinking, advisement, decision-making, reporting, and communication.

Responsibilities include the following:

• Review, determine applicability, and communicate new and proposed regulations for impact across the organization.
• Facilitate proactive readiness for changes to the Star program by driving public comment period review for the Stars organization including written response for Stars-related proposals and analysis and summary of competitor comments and positions.
• Establish internal clinical council focusing on advocacy opportunity with NCQA measure steward.
• Provides tracking, analysis, and reporting of current and emerging industry related activities.
• Participation in enterprise work related to achievement of Humana policy / advocacy goals.
• Manage strategic and collaborative relationships with key stakeholders.

Success in the role requires the following key attributes:

• Thrive in a highly collaborative, nimble, flexible and team-oriented work group
• Rapidly build and maintain trust with business leaders
• Ability to understand, research and summarize key points and impact of healthcare regulations
• Proven track record of exceptional organizational and problem-solving skills which support and enable sound decision making
• Exceptional relationship building skills and executive poise
• High self-initiative, commitment and follow through with ability to switch among competing tasks and priorities

Use your skills to make an impact
 

Required Qualifications

• Bachelor's degree
• 5 years of healthcare related legal, regulatory, and/or policy advocacy experience
• 3 or more years of cross-functional project leadership experience, to include leading teams through full process implementation
• Proficiency in evaluating complex problems and using qualitative and quantitative data to tell a story
• Demonstrated excellence in technical writing, facilitation, and other oral and written communications
• Proficient in use of Microsoft Office products (Word, Excel, PowerPoint)

Preferred Qualifications

• Knowledge of the Stars program
• Familiarity with CMS regulations
• Experience with PowerBI
• Process Improvement certification
• Strong analytical skills

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
• Associates 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 associates 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

Additional 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.

Scheduled Weekly Hours

40

Pay 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.

$115,200 - $158,400 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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: 03-10-2025
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.