Required Experience & Qualifications:

Minimum Qualifications:

• 5+ years of direct experience in healthcare quality operations, with a strong focus on Medicare STARS program metrics, HEDIS reporting, or risk adjustment.
• STARS/HEDIS Subject Matter Expert: Strong, foundational knowledge of NCQA guidelines, HEDIS specifications, and Medicare Star Ratings.
• Data & Analytics (Looker): Direct experience using Looker (or similar business intelligence tools) to track key performance indicators (KPIs), monitor throughput, and make data-driven staffing decisions.
• Systems Fluency: Practical, hands-on experience navigating major EMR platforms and cloud-based contact center telephony platforms.
• High proficiency in G Suite / Google Workspace (Docs, Sheets, Slides, Drive) to create client presentations, manage operational trackers, and facilitate meetings.
• WFM & Staffing Calculations: Demonstrated ability to project staffing needs and scale personnel dynamically based on data throughput during peak HEDIS seasons.

Preferred Qualifications:

• Client Management: 2+ years of experience in a client-facing role, managing corporate healthcare clients, payers, or enterprise accounts.
• Proven Gap Closure Performance: Deep experience managing end-to-end measure closures and executing targeted interventions to boost performance.
• Strategic STARS Planning: Experience assisting with or designing strategic initiatives to achieve and maintain the ratings.
• Executive Presentation: Exceptional communication skills with the ability to translate complex operational data into clear, actionable updates for executive leadership and clients.
• Vendor & Scaling Experience: Proven track record of managing third-party vendor contracts and rapidly scaling temporary contractor workforces during seasonal ramp-up periods.

Additional Information

Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.

Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Fuze Health’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.

Salary and Benefits

• Salary Range: $172,000-$215,000
• Commission Eligible: No
• Travel: Yes - Required up to 5% of the time
• Location Requirement: Fuze Health is limited to individuals residing in the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin.
• Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S.
• Benefits: Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&D) insurance, flexible spending account (FSA) and health savings account (HSA), commuter benefits, employer-paid short-term (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non-exempt employees), and eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month.

More Benefits Information Here: Fuze Health Benefits Site.

Application deadline: October 5, 2026

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Equal Opportunity Employer

Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com.

Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.

Use of Automated Decision Tools

Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us at talent@fuzehealth.com.

Privacy Notice

To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants.