Director, Enterprise Activation Provider Performance Strategy

About this role

Become a part of our caring community   The Director, Enterprise Activation Provider Performance Strategy is responsible for leading Enterprise Activation's provider performance infrastructure, including provider strategy, provider programs, reporting and dashboard capabilities, provider technology solutions, connectivity initiatives, data quality, and performance governance. This leader develops and optimizes the tools, programs, insights, and operational capabilities that support providers, markets, and enterprise partners in improving Medicare Stars performance and health outcomes.

The role serves as the enterprise owner for provider-facing capabilities—including reporting, performance frameworks, provider optimization programs, and technology-enabled solutions—and works closely with PCP Enablement and Market Consultation teams to ensure enterprise capabilities are effectively deployed and utilized. This role focuses on building and optimizing provider performance capabilities, while complementary Enterprise Activation teams drive provider adoption, engagement, and market execution.

Primary Enterprise Stars Focus:

Provider Performance Strategy Provider Programs & Incentives Provider Reporting & Dashboards Compass & Availity Roadmaps Provider Technology & Connectivity NSP Strategy & Performance Data Quality & Performance Integrity Performance Management Frameworks Vendor Strategy & Optimization Reporting Governance & Prioritization Performance Infrastructure & Capability Development

The Director, Enterprise Activation Provider Performance Strategy serves as the enterprise Stars leader responsible for Stars Market/provider performance strategy, provider-focused Stars optimization programs, provider reporting capabilities, technology enablement, data connectivity, performance governance, and provider ecosystem effectiveness to drive Stars performance.

This leader develops and advances the provider-facing systems, tools, reporting, technologies, and programs that enable providers to improve quality performance, close care gaps, enhance member outcomes, and drive Medicare Stars results. The role partners closely with enterprise teams including Markets, Provider Enablement, Clinical, Digital, Analytics, Operations, IT, and external provider organizations to ensure enterprise provider strategies are aligned, scalable, and outcome-focused.

The Director is responsible for creating a comprehensive provider performance ecosystem that integrates reporting, technology, incentives, data, workflow solutions, and provider programs into a cohesive strategy that advances enterprise quality, Stars performance and experience.

Key Responsibilities

Stars Provider Performance Business Systems Strategy • Lead the Stars strategy, governance, and optimization of enterprise provider reporting, dashboards, provider facing feature functionality, action-planning capabilities, reporting rules, and performance management tools to ensure provider and market-facing insights are actionable, scalable, intuitive, and aligned to workflow.

Stars Provider Technology & Connectivity Strategy • Lead enterprise Stars provider technology and connectivity strategy across Compass, Availity, POCA, provider data feeds, supplemental data submission, interoperability, and emerging workflow solutions by defining business requirements, improving usability, and partnering with Digital and IT to advance provider access to actionable performance information.

Stars Provider Programs & Vendor Performance Optimization • Lead governance, performance management, capability assessment, ROI/value realization, and optimization of provider-focused Stars programs and strategic vendor relationships, including Vatica, Stellar, Counterpart Health, Optum, and future provider-facing engagement and quality improvement solutions.

Stars Provider Ecosystem Strategy & Activation • Develop enterprise-wide Stars provider engagement, segmentation, activation, and optimization strategies that align reporting, incentives, programs, technology, Markets, Stars, and Provider organizations to improve quality performance, remove adoption barriers, and drive coordinated execution.

Travel is up 20%

Use your skills to make an impact   Role Essentials

• Bachelor's degree

• 8+ years of progressively responsible leadership experience in Medicare Advantage, provider performance, quality improvement, population health, healthcare analytics, provider engagement, or 5 years of experience at a top tier consulting firm

• 3+ years working experience in Medicare Advantage Stars, HEDIS, quality measurement, and provider performance improvement.

• Experience developing provider reporting, performance management, or provider engagement and experience strategies.

• Demonstrated experience analyzing provider quality and performance data across Medicare Advantage, Stars, HEDIS, value-based care, or related healthcare programs

• Experience leading enterprise-wide initiatives across multiple business functions.

• Strong strategic planning, business analysis, and program management skills.

• Experience managing complex stakeholder relationships across business and technology organizations.

Role Desirables

• Experience supporting provider groups, value-based care arrangements, and National Strategic Providers.

• Experience with provider-facing technology platforms and digital provider solutions.  

• Experience managing strategic vendor relationships and provider-facing solutions.

• Experience with healthcare interoperability, APIs, FHIR, HL7, and healthcare data exchange models.

Additional Information 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 criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

Satellite, cellular and microwave connection c

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