Description

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Director, Advisory Services - Stars Strategy & Performance is responsible for leading the growth, development, and delivery of Medicare Advantage Stars consulting services within the Quality & Risk Adjustment practice. This role serves as the executive subject matter expert for Stars strategy, governance, quality performance improvement, and CMS Star Ratings optimization, helping health plans navigate an increasingly complex regulatory environment while improving quality outcomes and maximizing Quality Bonus Payment opportunities. This role aligns with the practice's Stars-focused offerings, including strategy consulting, forecasting, governance, dashboards, CAHPS/HOS alignment, pharmacy performance, and interim Stars leadership services.

Strategic Value to the Practice:

This role is responsible for establishing and maintaining the practice's Stars market leadership position by developing differentiated advisory services, expanding executive-level client relationships, and integrating Stars capabilities across HEDIS, Clinical Quality, Risk Adjustment, Pharmacy, and Analytics. The Director drives growth in one of the most strategically important and financially impactful areas of payer consulting while ensuring the practice remains competitive as health plans face increasing pressure to improve Star Ratings performance and protect quality-based revenue streams.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Lead the growth and expansion of the Stars consulting practice, including solution development, business development, and client engagement strategy
• Serve as a trusted advisor to executive client stakeholders, including Medicare, Quality, Population Health, and Clinical Operations leadership
• Design and lead Stars performance improvement initiatives spanning HEDIS, CAHPS, HOS, Pharmacy, Provider, and Operational measures
• Develop Stars strategic roadmaps, governance structures, forecasting models, and performance improvement plans
• Translate CMS regulations, methodology updates, and industry trends into actionable client strategies
• Partner across HEDIS, Clinical Quality, Risk Adjustment, Analytics, and Technology teams to develop integrated client solutions
• Lead strategic assessments, maturity evaluations, and Stars program redesign efforts
• Support sales pursuits, proposal development, thought leadership, and market-facing Stars offerings
• Provide executive oversight for Stars-related delivery engagements and ensure successful client outcomes
• Mentor and develop Stars consultants and emerging quality leaders within the practice

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 8+ years of healthcare experience with significant Medicare Advantage Stars expertise
• Demonstrated experience leading Stars strategy, quality improvement, quality operations, or Medicare performance programs
• Experience presenting to executive leadership and influencing cross-functional stakeholders
• Deep understanding of CMS Star Ratings, CAHPS, HOS, Part D performance, Quality Bonus Payment methodology, and performance forecasting
• Demonstrated consulting, client relationship management, and business development skills.
  Proven ability to lead complex transformational initiatives and drive measurable performance improvement.
• Demonstrated ability to identify automation opportunities and leverage AI to improve productivity and quality
• Must be able/willing to travel appropriately 50% of the time as business needs dictate

Preferred Qualifications:

• Advanced degree (MPH, MHA, MBA, PharmD, RN, or related healthcare discipline)
• NCQA, quality improvement, population health, or healthcare analytics certifications
• Experience serving as a Director of Stars, Director of Medicare Quality, Director of Population Health, or equivalent leadership role within a Medicare Advantage health plan
• Experience leading CAHPS, HOS, Pharmacy Quality, Risk Adjustment, and HEDIS initiatives as part of an integrated quality strategy
• Consulting experience with a national consulting firm, health care advisory practice, or managed services organization
• Experience leading large-scale Stars transformations, governance redesigns, operating model development, or enterprise quality programs
• Demonstrated experience developing and selling advisory services, scopes of work, and executive-level client solutions
• Experience working with Stars analytics platforms, forecast modeling tools, dashboards, and performance monitoring systems
• Experience presenting to executive leadership teams, boards, or quality governance committees
• Demonstrated understanding of Medicare Advantage financial mechanics, including Quality Bonus Payment (QBP), bid strategy impacts, and revenue implications associated with Star Ratings performance
• Proven success improving Star Ratings performance resulting in movement across key rating thresholds (3.5, 4.0, 4.5, or 5 Stars)
• Proven established relationships within the Medicare Advantage industry, including health plans, PBMs, provider organizations, and vendor partners
• Ability to identify emerging market trends and translate them into new consulting offerings and growth opportunities for the practice

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.