Director, CAHPS and HOS Strategy, Execution

This is a fully remote position, open to applicants in United States.

📋 Description

• Convert enterprise-wide CAHPS/HOS strategies into comprehensive operational roadmaps.

• Oversee the project lifecycle for initiatives aimed at enhancing member experience to support 5-Star performance.

• Lead the annual update, upkeep, and implementation of the Provider Playbook at the field level.

• Ensure that CMS Access to Care interventions are carried out effectively at both clinic and group levels.

• Analyze CAHPS/HOS data and performance metrics to pinpoint trends and areas for improvement.

• Formulate action plans in collaboration with operational leaders and network providers.

• Maintain over 60% field presence for conducting in-person provider performance reviews and implementing strategies on-site.

• Utilize partnerships with providers and high-impact contributors to enhance member experiences.

• Execute and oversee provider incentive programs that align with measurable improvements in CAHPS/HOS scores.

• Collaborate with Stars, Member Services, Member Retention, Network Management, and Quality teams.

• Act as a subject matter expert on CAHPS/HOS methodologies and changes in regulations.

• Prepare performance reports for senior leadership while emphasizing the return on investment of interventions.

• Advocate for service excellence, empathy, and ongoing improvement.

• Supervise assigned staff, including recruiting, training, managing workloads, conducting performance appraisals, coaching, counseling, and overall performance management.

• Carry out additional duties and projects as required.

⛳️ Requirements

• A minimum of 10 years of progressive leadership experience in healthcare quality, member experience, and provider performance enhancement.

• Experience in health plans, provider organizations, or healthcare settings focused on quality.

• Demonstrated success in improving CAHPS/HOS metrics within a Medicare Advantage context.

• Hands-on experience in driving provider engagement with proven results in CAHPS and HOS performance enhancement.

• Familiarity with provider contracting, particularly the integration of Quality/Stars components into agreements.

• Bachelor’s degree in Public Health, Healthcare Administration, Business, or a related discipline.

• Profound understanding of CAHPS and HOS methodologies, CMS Star Ratings, and quality improvement frameworks.

• Capability to lead cross-functional initiatives and achieve measurable enhancements in member experience.

• Strong written and verbal communication skills.

• Competence in performing mathematical calculations and accurately interpreting simple statistics.

• Ability to prioritize multiple tasks while applying advanced problem-solving and reasoning skills.

• Excellent organizational and time management abilities; adept at thriving in a fast-paced environment.

• Skill in comprehending and analyzing statistical reports.

• Consistent field presence of at least 60% for in-person provider engagements and on-site implementations.

• Expertise in CAHPS/HOS survey methodologies, regulatory changes, and CMS guidelines.

• Capacity for executive autonomy and the ability to communicate complex data insights to executive leadership.

• Capability to meet the specified physical functions, with reasonable accommodations where applicable.

🏝️ Benefits

• Chance for growth and innovation within the organization.

• Commitment to equal employment opportunity and affirmative action.