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Spectrum Health Director, Medicare Quality Stars - Priority Health in Grand Rapids, Michigan

CURRENT SPECTRUM HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Spectrum Health team members only.

Job Description

  • Leads Medicare Stars Team including analytics, program management and outreach activities; directs overall Stars improvement strategy, including identifying strategic focus areas, planning & execution of initiatives; allocates and monitors budget.

  • Conduit to our Executive Stars Steering Committee to communicate performance, get buy-in, and cascade the SteerCo messages back down to the Stars Team.

  • Collaborate with senior leaders to communicate Stars performance, align priorities, and obtain buy-in across the company on new initiatives.

  • Oversees organization-wide socialization of Medicare Stars improvement program performance and CMS regulatory updates.

  • Represents Medicare Stars program in provider JOC (in collaboration with provider team).

  • Collaborates with VP, Sr Markets on CMS advocacy & planning; oversees CMS submissions/interactions.

  • Oversees cultural transformation and organization-wide awareness of Medicare Stars.

  • Maintain close pulse on MA and Stars market insights, including competitive intelligence and emerging market trends.

  • Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis.

  • Performs other duties as assigned.

Basic Qualifications:

  • Bachelor's degree in nursing, pharmaceutical, health care management, or other related clinical degree or area required.

  • Master's degree (MPH or MBA) preferred.

  • Preferred clinical experience and knowledge.

  • 7 years of relevant experience as a strategic leader with demonstrated ability to collaborate with multiple business functions and drive change preferred.

  • Required expertise in quality improvement and patient safety tools and methodologies including statistical analysis, epidemiology, and clinical decision support systems including severity adjustment systems and a variety of benchmarking solutions.

  • Required demonstrated ability to lead and implement quality improvement and patient safety initiatives across large complex organizations.

Primary Location

SITE - Priority Health - 1239 E Beltline - Grand Rapids

Department Name

PH - Medicare - Leadership

Employment Type

Full time


Weekly Scheduled Hours


Hours of Work


Days Worked

Monday thru Friday

Weekend Frequency


Accommodation Notice: If you are a qualified individual with a disability, you may request a reasonable accommodation in Spectrum Health's application process. Contact us at 616-486-SHHR (7447).

Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected

category. See more here (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf) .

Who We Are

Spectrum Health is a nationally recognized not-for-profit health system, offering a full continuum of health services through our health plan, medical group and hospital group. As an integrated health system, we are able to work together across all facilities, employees and providers to create exceptional, consumer-focused interactions.

Spectrum Health is redefining what it takes to improve the health of our communities and introducing new and innovative ways for consumers to access high-quality, low-cost care so that they can connect with us for a lifetime of health.

We strive to provide one Spectrum Health experience: a consistent, high-quality, seamless health journey for consumers; no matter where, when or how they interact with us. The result is better health outcomes for the thousands of individuals, families and communities we serve.

We are the region’s largest employer, with corporate offices located in Grand Rapids, Michigan. Spectrum Health Hospital Group and Spectrum Health Medical Group are consistently recognized for the exceptional care they provide. Priority Health is among the largest health system-sponsored health plans in the U.S. and offers extensive experience serving large and small employer groups, individuals, Medicare Advantage, Healthy Michigan Plan and Medicaid populations.

Since 2010, Spectrum Health has been listed five times among the 15 Top Health Systems in the U.S. by Truven Analytics™. Click here (https://www.spectrumhealth.org/about-us/quality-safety-and-patient-experience/awards) to see a complete list of our safety, quality and patient experience awards.