Director, Stars Operations
 SCAN Group | |
$147,900 to $214,030
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paid holidays, tuition reimbursement, 401(k)
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 United States, California, Long Beach | |
| 3800 Kilroy Airport Way (Show on map) | |
 Mar 04, 2026 | |
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Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12 Angry Seniors." Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen-not dilute-our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. The Director, Stars Ops will lead and integrate STARS Rx Operations, HEDIS vendor wrap-around services, and performance management to drive sustainable improvement in STARS ratings. Serve as a key partner to Quality, Clinical, Pharmacy, Network, and Vendor teams to align execution with enterprise quality goals Key Responsibilities: * Own overall STARS operational strategy and execution across medical and pharmacy domains. * Provide direct leadership and oversight of STARS Rx Operations, ensuring alignment with CMS requirements and quality improvement priorities. * Translate STARS and HEDIS requirements into actionable operational plans with clear accountability. HEDIS & Vendor Management * Lead HEDIS vendor wrap-around services, including oversight of supplemental data, chart retrieval, abstraction, and validation processes. * Establish strong governance, performance expectations, and accountability with external vendors. * Monitor vendor performance against SLAs, quality benchmarks, and timelines, and implement corrective actions as needed. Performance Management & Analytics * Drive performance management processes to track Rx Ops & HEDIS measure performance, trends, risks, and opportunities. * Partner with analytics teams to ensure timely, accurate reporting and actionable insights. * Develop and maintain dashboards, scorecards, and executive-level reporting for quality outcomes. Technology Enablement & Data Integration * Partner with Medical Groups and IT to operationalize the quality technology stack supporting STARS Rx and HEDIS, enabling actionable reporting, gap identification, and performance improvement at the provider and member level. Quality Outcomes & Continuous Improvement * Lead initiatives to improve measure performance, close gaps in care, and optimize member and provider engagement strategies. * Identify root causes of underperformance and implement sustainable corrective and preventive actions. * Ensure continuous readiness for audits, data validation, and CMS reviews. Cross-Functional Collaboration * Partner closely with Clinical, Pharmacy, Network, Operations, Compliance, and IT teams to drive integrated STARS execution. * Influence and align senior leaders and stakeholders around quality priorities and operational trade-offs. * Act as a subject matter expert and thought leader for STARS operations and quality performance. Governance, Risk & Compliance * Ensure compliance with CMS, NCQA, and regulatory requirements related to STARS, HEDIS, and pharmacy measures. * Proactively identify operational and regulatory risks and implement mitigation strategies. * Support internal and external audits and regulatory inquiries. People & Change Leadership * Lead, coach, and develop high-performing teams responsible for STARS operations and vendor oversight. * Foster a culture of accountability, transparency, and continuous improvement. * Drive change management efforts to support new initiatives, regulatory updates, and evolving quality strategies. You Will Strategic Leadership: Develop and execute strategies to meet and exceed Medicare Stars performance targets. Drive improvement in clinical quality metrics, with a focus on Rx adherence measures (statin use, hypertension medication adherence, etc.). Monitor regulatory updates and ensure compliance with CMS Star Ratings requirements. Clinical Metrics Management: Analyze performance data and trends for clinical metrics to identify improvement opportunities. Collaborate with clinical teams to develop and implement interventions to enhance outcomes. Lead efforts to optimize medication adherence programs and support pharmacy-related initiatives. Operational Excellence: Oversee daily operations related to quality initiatives, ensuring seamless execution and alignment with organizational goals. Develop processes to streamline workflows, enhance efficiency, and achieve measurable results. Foster a culture of continuous improvement and accountability across teams. Vendor Oversight: Manage relationships with external vendors, ensuring contractual obligations and quality deliverables are met. Evaluate vendor performance through established metrics and implement corrective actions when necessary. Serve as the primary liaison between vendors and internal stakeholders, promoting collaboration and alignment. Cross-Functional Collaboration: Partner with member experience, healthcare services, pharmacy, and IT teams to design and execute initiatives. Communicate performance outcomes and improvement plans to executive leadership and stakeholders. Lead or participate in workgroups to address system-wide challenges affecting Stars performance. Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.) We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN's Vision and Goals. Other duties as assigned. Your Qualifications Bachelor's Degree or equivalent experience. Graduate or Advanced Degree or equivalent experience preferred. 7+ years of experience in a Medicare managed care or provider organization. 7+ years of experience in Medicare Star rating program. Leadership - Skilled to develops others Business Insight - In-Depth understanding of the business Problem Solving - Good problem-solving skills Strategic Mindset - Creates strategies to sustain competitive advantage Strong verbal and written communication skills. Ability to analyze and synthesize complex information. Excellent organizational, decision-making, and multi-tasking skills. Ability to prioritize multiple and competing tasks, work independently and in a team environment. Proficient in MS Office What's in it for you?
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now! At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more. SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. #LI-CS2 #LI-Remote Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c) | |