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Job Posting Title

Director Stars and Quality - remote

Job Description

The Director Stars and Quality is responsible for the client consultation strategy and execution for Prime's Star Rating and Quality program. This role will collaborate closely with Prime's Center of Excellence as the voice of the client to inform enterprise strategic planning as well as manage a team who translates the enterprise strategy into client specific strategic plans that achieve Star Ratings and quality outcomes for Medicare, Medicaid, Individual Health Insurance Marketplace, and Commercial lines of business.

This position oversees end-to-end client quality management including RFP/sales process, contract development, support model development, client retention, and performance guarantees.

Responsibilities

+ Develop and drive the client quality support model strategy for all lines of business (Medicare, Medicaid, commercial/HIM); serve as primary enterprise point of contact and subject matter expert on all client quality matters and collaborate with enterprise partners to enhance the support model.

+ Develop client quality strategic plan and manage execution to ensure initiatives are on schedule and within budget.

+ Provide leadership in clients meetings to gather voice of the customer feedback, ensure client needs are being met, and performance metrics are achieved.

+ Demonstrate in-depth understanding of Star Ratings and quality matters including regulatory compliance, market intelligence, and drive innovative solutions to support client quality strategy.

+ Build external client satisfaction by ensuring successful complex quality initiatives; establish client-facing relationship and develop influence with health plan quality leaders.

+ Work Collaboratively throughout enterprise and Center of Excellence to develop organization-wide quality strategy that supports clients and client quality team.

+ Embody culture of growth mindset, continuous quality improvement, and provide couching and development for team.

+ Other duties as assigned.

Education & Experience

+ Bachelor's degree in clinical, business administration or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required.

+ 8 years of leadership/management experience.

+ Experience with Star Ratings and Quality.

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

+ Proven ability to effectively distill complex information into clear and compelling presentations.

+ Strong verbal and written communication.

+ Ability to think strategically and demonstrate strong problem-solving skills.

+ Excellent interpersonal skills, with the ability to effectively facilitate meetings, resolve conflict, build consensus and influence, and collaborate effectively across departments, internally and externally, and at all levels within an organization.

+ Demonstrated ability to identify and implement practices and process improvement.

+ Proven organization and prioritization skills, superior attention to detail, and the ability to simultaneously manage multiple, complex projects, under pressure and strict timeframes, without compromising quality.

+ Excellent client relationship management skills.

Preferred Qualifications

+ Master's degree in clinical, business, education, or other relevant discipline.

+ 8+ years of leadership/people management experience.

+ 8+ years of work experience in Pharmacy Benefits Management (PBM), integrated health system or health plan experience.

Physical Demands

+ Ability to travel up to 15% of time.

+ Constantly required to sit, use hands to handle or feel, talk and hear.

+ Frequently required to reach with hands and arms.

+ Occasionally required to stand, walk and stoop, kneel, and crouch.

+ Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.

+ Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.

_Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.   _

_We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._

_Prime Therapeutics LLC is a Tobacco-Free Workplace employer._

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].