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Job ID #108521 Humana

Stars Vendor Performance Lead

Jefferson City, MO
description

Summary

Become a part of our caring community

The Program Lead, Enterprise Clinical Partnerships (ECP) Performance Management, is responsible for driving the success of Humana's portfolio of enterprise clinical partnerships through strategic oversight, performance management, operational governance, and cross-functional collaboration. This role serves as a key connector between internal business partners and external clinical vendors to ensure programs deliver measurable value for members, providers, and Humana.

The Stars Vendor Performance Lead will lead performance improvement initiatives, develop executive insights and recommendations, drive accountability across stakeholders, and enhance Humana's performance management capabilities through data-driven decision-making and operational excellence. This individual must be comfortable operating in ambiguity, influencing across a highly matrixed organization, and translating complex data into actionable strategies. A strong understanding of Medicare Advantage quality performance, Stars, HEDIS measures, and population health outcomes is critical to ensuring clinical partnerships contribute to enterprise quality goals and member outcomes.

The Enterprise Clinical Partnerships Performance Management team is responsible for evaluating, monitoring, and improving the performance of Humana's specialty and clinical vendor partnerships. The Program Lead works across Clinical Strategy, Quality, Market Operations, Analytics, Care Management, Product, Finance, Network, and Vendor Management teams to drive outcomes, optimize performance, and support enterprise objectives.

This role combines strategic thinking, operational leadership, analytics, and stakeholder management to identify opportunities, solve complex business challenges, and advance Humana's value-based care strategy. The Program Lead develops performance frameworks, facilitates governance processes, and delivers actionable recommendations to senior leadership while ensuring vendor initiatives align with Stars, HEDIS, quality improvement, and member experience priorities.

In This Role You Will

+ Lead performance management activities across a portfolio of Enterprise Clinical Partnership programs and vendors.

+ Develop and maintain program health scorecards, performance dashboards, executive reporting, and business reviews.

+ Analyze clinical, operational, financial, enrollment, engagement, Stars, HEDIS, and quality performance metrics to identify opportunities and risks.

+ Partner with internal and external stakeholders to define improvement initiatives, action plans, and measurable outcomes tied to quality and performance objectives.

+ Facilitate vendor performance reviews, quarterly business reviews (QBRs), and governance meetings.

+ Identify opportunities for partnerships to improve quality outcomes, care gap closure, preventive care compliance, medication adherence, member experience, and population health performance.

+ Translate complex performance challenges into structured analyses, actionable recommendations, and operational solutions.

+ Lead cross-functional initiatives that improve program performance, operational effectiveness, member outcomes, and quality results.

+ Develop executive-ready presentations, business cases, and strategic recommendations for senior leadership.

+ Identify trends, emerging risks, and growth opportunities across the ECP portfolio and recommend strategic actions.

+ Partner with Quality, Clinical Strategy, and Analytics teams to evaluate vendor contributions to enterprise quality goals and Medicare Advantage performance.

+ Support implementation of new performance management capabilities, tools, processes, and reporting frameworks.

+ Foster strong relationships with vendors and internal stakeholders to drive accountability, collaboration, and continuous improvement.

+ Drive consistency and best practices across enterprise clinical partnership performance management activities.

Use your skills to make an impact

Role Essentials

+ Bachelor's Degree

+ 7+ years of experience in healthcare operations, strategy, performance management, consulting, quality improvement, vendor management and/or program management

+ 3+ years of experience leading complex cross-functional initiatives

+ Experience using data and performance metrics to drive business decisions and improvement initiatives

+ Knowledge of Medicare Advantage quality programs, Stars measures, HEDIS performance, and quality improvement methodologies

+ Experience evaluating and interpreting quality performance metrics, care gap opportunities, and population health outcomes

+ Proven ability to develop executive-level presentations and communicate complex findings to senior leadership

+ Experience developing performance scorecards, dashboards, governance processes, or operational reporting frameworks

+ Advanced PowerPoint and Excel skills

+ Exceptional written and verbal communication skills

Role Desirables

+ Experience with AI technology such as: CoPilot or Claude

+ Experience with value-based care, population health, specialty care, or clinical vendor partnerships

+ Experience managing external vendor performance and contractual accountability

+ Knowledge of quality improvement, healthcare analytics, risk adjustment, care management operations, and population health management

+ Master's degree in Business Administration, Healthcare Administration, Public Health, or related field

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 can be used only if approved by leadership.

Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for you.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

Work at Home Requirem...