Blue Cross Blue Shield Of Massachusetts
Healthcare
VicePresident,Stars&RiskAdjustmentPerformance
Neural analysis suggests this role is
optimal for Senior candidates.
“Vice President, Stars & Risk Adjustment Performance at Blue Cross Blue Shield Of Massachusetts. Skills: Stars and Risk Adjustment initiatives, multi-year business plan for Stars and Risk Adjustment, performance targets and Key Performance Indicators (KPIs), provider network engagement strategies, cross-functional teams, strategic plan execution. directing and monitoring all Stars and Risk Adjustment initiatives. developing a unified strategy to drive efficiency and effectiveness across both prog”
What You'll Achieve.
achieve optimal outcomes; drive efficiency and effectiveness across both programs; improve performance; maximize provider engagement to support financial goals; ensure the long-term success of the Medicare Advantage business; drive performance targets and Key Performance Indicators (KPIs) for both Stars and Risk Adjustment programs
Industry & Context.
Demonstrated strength in analysis, problem identification, and resolution; Demonstrated ability to take ownership of problems and independently develop solutions
What They're Looking For.
Must Have
15 years of leadership experience in Medicare Advantage Stars and/or Risk Adjustment, Bachelor's Degree required, High school degree or equivalent required
What You'll Do.
directing and monitoring all Stars and Risk Adjustment initiatives
developing a unified strategy to drive efficiency and effectiveness across both programs
leveraging data and analytics to improve performance
maximizing provider engagement to support financial goals
communicating program results
advocating for Medicare business interests in cross-functional projects
oversee a subject matter expert team for Stars program management and a full Risk Adjustment team
Develop and execute a multi-year business plan for Stars and Risk Adjustment
and drive performance targets and Key Performance Indicators (KPIs) for both Stars and Risk Adjustment programs
Lead provider network engagement strategies to improve performance in Stars and Risk Adjustment
Lead regular meetings with cross-functional teams
Analyze and communicate the business implications of federal legislative changes
and competitive threats
providing recommendations for action
How You'll Work.
Team & Collaboration
collaborate with key stakeholders; influence a wide range of partners—including clinical, quality, analytics, member experience, and provider relations teams; Lead regular meetings with cross-functional teams, including Pharmacy, HEDIS, CAHPS, HOS, Operations, Provider Network and Analytics; collaborate with corporate planning leaders to execute a strategic plan; Ability to lead and manage deliverables through others in a highly matrixed environment; interact effectively with all levels of the organization and external parties
Communication Scope
exceptional communication skills; Excellent written, verbal, and interpersonal communication skills
Process & Methodology
managing multiple projects simultaneously
Full Job Description
## **Ready to help us transform healthcare? Bring your true colors to blue. ** Job Title: Vice President, Stars & Risk Adjustment Performance Reports to: Senior Vice President, Government Programs Position Overview The Vice President of Stars & Risk Adjustment Performance is a strategic and analytical senior leader responsible for directing and monitoring all Stars and Risk Adjustment initiatives to achieve optimal outcomes. This role involves developing a unified strategy to drive efficiency and effectiveness across both programs, leveraging data and analytics to improve performance, and maximizing provider engagement to support financial goals. The Vice President will collaborate with key stakeholders to communicate program results and advocate for Medicare business interests in cross-functional projects. This critical leadership position will influence a wide range of partners—including clinical, quality, analytics, member experience, and provider relations teams—to ensure the long-term success of the Medicare Advantage business. The ideal candidate is a natural leader with exceptional communication skills and a persuasive, thoughtful approach. Direct Reports This position will oversee a subject matter expert team for Stars program management and a full Risk Adjustment team, including management, data analysts, and risk coders. Key Responsibilities * Develop and execute a multi-year business plan for Stars and Risk Adjustment, analyzing the interrelationships of product, operations, and program performance. * Establish, track, and drive performance targets and Key Performance Indicators (KPIs) for both Stars and Risk Adjustment programs. * Lead provider network engagement strategies to improve performance in Stars and Risk Adjustment. * Maintain expert knowledge of CMS regulations, industry trends, and best practices in Medicare Stars and Risk Adjustment. * Lead regular meetings with cross-functional teams, including Pharmacy, HEDIS, CAHPS, HOS, Operations, Provi
Applying for this Vice President, Stars & Risk Adjustment Performance role?
Most applicants get filtered before a human reads their resume. See if yours makes the cut.
How to Apply on Workday
- Workday has a multi-step form — save your progress after every section.
- "Apply With LinkedIn" can fail or lose data; manual entry is more reliable.
- Watch for the "Submit for Review" final step — hitting "Save" alone does not submit.
- Job requisition numbers are useful when following up with HR by email.
ANONYMOUS · UNFILTERED
What do employees actually say about Blue Cross Blue Shield Of Massachusetts?
Real rants from real employees. Read before you apply.