Sr. Director, STAR Intervention

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first.We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Senior Director, STARs Interventions is responsible for leading the design, integration, and execution of clinical interventions aligned to CMS STAR measures within the Medicare Advantage clinical operating model. This role ensures STAR quality performance is fully embedded into clinical workflows, care management programs, provider engagement strategies, and population health initiatives.
The Senior Director serves as the clinical operations owner for Clinical STAR measures (Part C and D) execution, translating regulatory quality measures into actionable clinical processes that drive sustainable improvement in STAR ratings, member outcomes, and organizational performance.

Job Responsibilities:

Clinical Integration of STAR Measures

• Translate CMS Clinical STAR measures (Part C and D) into operational clinical priorities, workflows, and care pathways across clinical operations.
• Embed Clinical STAR measures (Part C and D) requirements into care management, utilization management, population health, and member engagement programs.
• Ensure alignment between clinical model design and Clinical STAR measures (Part C and D) performance objectives.

Clinical Intervention Design & Execution

• Design, implement, and oversee multi-modal clinical interventions aimed at closing Clinical STAR measures (Part C and D) gaps, including preventive care, chronic condition management, medication adherence, and proactive member outreach initiatives.
• Develop intervention strategies tailored to member risk stratification and population needs.
• Own intervention planning, operational readiness, execution timelines, and scalability.

Cross-Functional Leadership

• Partner closely with Stars, Analytics, Pharmacy, Network Management, Provider Engagement, and Population Health teams to ensure coordinated Clinical STAR measures (Part C and D) initiative/intervention execution.
• Serve as the primary clinical operations liaison for Clinical STAR measures (Part C and D) performance initiatives for Stars team.
• Align internal teams and external partners around shared quality and performance goals.

Provider & Clinical Team Enablement

• Support provider-facing and clinical teams with clear guidance, tools, and workflows that enable Clinical STAR measures (Part C and D) gap closure.
• Collaborate with network and value-based care teams to integrate Clinical STAR measures (Part C and D) into provider engagement and performance strategies.

Performance Management & Accountability

• Establish and monitor key performance indicators related to Clinical STAR measures (Part C and D) intervention effectiveness, including gap closure rates, intervention yield, and clinical outcomes.
• Lead performance reviews and operational oversight of Clinical STAR measures (Part C and D) related programs and vendor partners under clinical operational preview.
• Drive corrective action plans to address underperformance and maximize results.

Continuous Improvement & Innovation

• Identify opportunities to enhance clinical workflows, reduce administrative burden, and improve member and provider experience to align with CMS regulatory guidance and specifically Star ratings program.
• Pilot and scale innovative clinical intervention approaches, including digital, in-home, and community-based models.
• Monitor CMS regulatory changes and proactively adapt clinical strategies to evolving STAR requirements.

Job Requirements:

Experience:

Required:

• 8+ years of progressive experience in Medicare Advantage, clinical operations, population health, or quality improvement.
• Deep understanding of CMS STAR measures and Medicare Advantage quality programs.
• Proven track record of operationalizing clinical quality initiatives within clinical care delivery environments.
• Experience managing cross-functional teams and external vendors.

Education / Training:

Required: Master’s degree in Healthcare Administration, Public Health, or related field

Preferred:

• Lean Six Sigma, other processes improvement certification, Certified Professional in Healthcare Quality (CPHQ), or Certified Professional in Healthcare Management (CPHM)

Specialized Skills:

Required:

• Deep understanding of CMS STAR measures and Medicare Advantage regulatory requirements.
• Strong knowledge of clinical operations, care management, and population health models.
• Ability to translate regulatory and quality standards into practical clinical workflows.
• Exceptional leadership, collaboration, and influencing skills.
• Data-driven mindset with the ability to interpret performance metrics and drive action.
• Excellent communication and executive presentation skills.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $149,882.00 - $224,823.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].

Originally posted on Himalayas