Associate Director, STARS & HEDIS
Quality and Risk Adjustment | Virtual - Any US CINQCARE Location | Full Time | From $120,000 to $130,000 per year
Why Join CINQCARE?
CINQCARE is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to high-needs, urban and rural communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patient’s race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day. Join us in creating a better way to care.
Position Overview
The Associate Director, STARS & HEDIS reports to the Director- Practice Performance with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded.
Key Responsibilities
The Associate Director, STARS & HEDIS will have the following responsibilities:
HEDIS Measurement & Reporting
- Oversee the accurate collection, analysis, and submission of HEDIS data to payer partners.
- Ensure data integrity and compliance with HEDIS cut points and regulatory requirements.
- Lead the annual HEDIS reporting process, including timeline management and external audit preparation.
- Demonstrate knowledge in Medicaid and Medicare metrics and reporting methods.
Data Analysis & Quality Improvement
- Conduct data analysis to identify trends, performance gaps, and opportunities for HEDIS score improvements.
- Provide data-driven insights to leadership to support quality improvement initiatives.
- Collaborate with clinical and operational teams to develop action plans for performance enhancement.
Compliance & Auditing
- Ensure adherence to NCQA, CMS, and other regulatory guidelines related to HEDIS reporting.
- Manage internal PSV audits and prepare for external reviews.
- Maintain compliance documentation and support regulatory submissions.
Cross-Functional Collaboration & Process Improvement
- Partner with clinical, IT, and operational teams to streamline data collection and reporting.
- Support staff training and development on accurate data reporting, quality measures, and SDS mapping.
- Work with EMR and claims teams to optimize data extraction and reporting accuracy.
Strategic Planning & Leadership
- Develop and implement long-term strategies to enhance HEDIS performance and align with organizational quality goals.
- Lead quality improvement programs aimed at improving member outcomes and provider engagement.
- Provide mentorship and leadership to analysts and coordinators, fostering a high-performing team environment.
Required Qualifications
The Associate Director, STARS & HEDIS should have the following qualifications:
- Education. Bachelor’s or equivalent degree;
- Experience. Ideal candidates will have 5+ years of relevant work experience in the healthcare industry; 5+ years of supervisory experience; Experience with STARS & HEDIS measures;
- Communication. Excellent verbal, written communication and presentation skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQ’s team, investors, partners and other stakeholders. Proficiency in all Microsoft Office applications;
- Relationships. Ability to build and effectively manage relationships with business leaders and external constituents; and
- Culture. Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding and entrepreneurial Company.
Our Benefits
At CINQCARE, we care for our team like we care for our patients—holistically. We offer flexible, comprehensive benefits so you can thrive while delivering top-notch care.
- Medical Plans: Two options, including a $0 cost plan for individuals.
- 401K: 4% employer match for your future.
- Dental & Vision: Flexible plans with in-network savings.
- Paid Time Off: Generous PTO, holidays, and wellness time.
- Extras: Pet insurance, commuter benefits, mileage reimbursement, CME for providers, and company-provided phones for field staff.
The working environment and physical requirements of the job include:
Work is performed indoors in a setting with conditioned air and artificial light. Travel to and work in offices or other environments is required.
In this position you will need an to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 10 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.