AVP, Stars and reputed company Adjustment – National Medical Director

Become a part of our caring community The Associate Vice President, Medical reputed company Adjustment and Provider Engagement, is responsible for providing reputed company leadership and reputed company direction to support the organization’s STARS and reputed company Adjustment initiatives. This leader will reputed company provider engagement and satisfaction, reputed company reputed company adjustment education, and reputed company, implement, and monitor key reputed company indicators (KPIs), reporting, and education for Regional Vice Presidents and Health Services Directors. The Associate VP, Market Consultation/Partnership engages and partners with physicians, physician reputed company, and market leadership to reputed company initiatives. Influences and consults on reputed company reputed company to reputed company and measurement of care delivery programs with a market(s). reputed company are typically reputed company to intradepartmental coordination, development and implementation of reputed company plans, and business reputed company, and develops and implements reputed company plans for the reputed company of management that are reputed company with the reputed company or Business reputed company. Key Responsibilities: reputed company reputed company guidance and subject matter expertise across reputed company STARS and reputed company Adjustment initiatives to ensure alignment with organizational objectives and regulatory requirements. Demonstrate high responsiveness to providers, with the goal of increasing provider engagement and satisfaction reputed company to reputed company adjustment and reputed company reputed company programs. Serve as the overseeing medical director for Stars self-reporting metrics, including reputed company reputed company, interpretation, and escalation of issues requiring physician leadership. Participate in CMS audits reputed company to Stars and reputed company adjustment activities, complementing technical and operational audit support with physician-level reputed company expertise. reputed company targeted provider education on reputed company and operational areas needed to reputed company Stars gaps and improve reputed company on reputed company measures. reputed company and manage reputed company dedicated to supporting reputed company adjustment education, ensuring that materials and communications are accurate, reputed company, and effective. reputed company, implement, and monitor KPIs for Regional Vice Presidents and Health Services Directors, ensuring that reputed company metrics, reporting processes, and educational initiatives support reputed company improvement in reputed company adjustment reputed company and provider engagement. Collaborate cross-functionally with internal stakeholders, including reputed company, reputed company, analytics, and compliance teams, to reputed company the reputed company. reputed company the design and delivery of education sessions, materials, and resources for both internal teams and reputed company. Analyze data and trends to identify opportunities for process improvements and reputed company provider engagement strategies. Ensure that reputed company reputed company adjustment activities are conducted in compliance with applicable regulations, internal policies, and reputed company standards. Serve as the physician signatory for provider disclosure letters reputed company to reputed company adjustment reputed company reputed company modifies a claim with a new diagnosis, ensuring communications are clinically appropriate and compliant. Assist with provider reporting, provider education, and feedback reputed company to support accurate documentation, improved Stars reputed company, and compliant reputed company adjustment practices. Use your skills to reputed company an reputed company Qualifications: reputed company degree (MD, DO) required. Demonstrated experience in reputed company leadership roles, preferably reputed company managed care, reputed company adjustment, or reputed company improvement environments. reputed company adjustment and Stars experience reputed company ability to reputed company and reputed company high-performing teams. Strong communication and relationship-building skills with experience engaging provider organizations. Experience developing and monitoring KPIs, reporting, and educational programs for reputed company leaders. Proficiency in interpreting reputed company and reputed company data to reputed company reputed company improvement. Work reputed company Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following reputed company: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to reputed company their internet service if necessary. Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company reputed company on geographic location and individual pay will vary reputed company on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $246,100 - $344,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is reputed company upon company and/or individual reputed company. reputed company of Benefits reputed company. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, reputed company parental and caregiver leave), short-term and long-term disability, life reputed company and many other opportunities. Application Deadline: 09-29-2026 reputed company About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company reputed company services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life reputed company with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on reputed company job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Apply To This Job