Vice President, Quality, Stars, Risk Adjustment and Performance Operations
Position: _Vice President, Quality, Stars, Risk Adjustment and Performance Operations_The Vice President, Quality, Stars, Risk Adjustment, and Performance Operations will lead Monogram Health’s enterprise strategy and operational execution across all products, with an emphasis on Medicare Advantage, Quality Stars, HEDIS, Risk Adjustment, Clinical Documentation Improvement, and compliance standards. This role will collaborate across departments to translate strategy into scalable workflows, clear accountability, and measurable performance results.
Responsibilities
- Lead Monogram Health’s enterprise strategy and end-to-end performance for Quality, Stars, HEDIS, Risk Adjustment, and clinical documentation improvement.
- Set annual and long-range goals, operating plans, milestones, and accountability, and drive execution and corrective action across the organization.
- Develop payer specific strategies that reflect contractual requirements, performance methodologies, financial incentives, data availability, and operational opportunities.
- Own trusted scorecards, forecasts, and reporting with clear definitions, validated data, and reconciliation across clinical, payer, CMS, and financial sources.
- Partner with Finance, Actuarial, and Medical Economics to quantify and forecast the revenue, medical cost, and margin implications of performance.
- Translate opportunities into scalable clinical and operational workflows by defining requirements and priorities for clinical, product, analytics, and technology teams.
- Lead governance and executive reviews, remove barriers, resolve competing priorities, and hold internal teams and external partners accountable for results.
- Manage payer relationships and exte...
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