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Job Title: Lead Director, Solutions Architect – Epic Applications (STARS Reporting & Care Coordination/Healthy Planet)
Position Summary
The Lead Director, Solutions Architect – Epic Applications is a senior technical and strategic leader responsible for the architecture, design, and delivery of Epic solutions supporting Medicare Star Ratings (STARS) reporting, care coordination, and population health management via Epic Healthy Planet. This role bridges deep Epic technical expertise with a strong understanding of value-based care, quality measures, and risk adjustment, translating regulatory and business requirements into scalable Epic architecture. The ideal candidate has led enterprise-level Epic initiatives, understands the data and workflow demands of STARS/HEDIS/quality reporting, and can architect solutions that span Healthy Planet, Care Everywhere, Reporting Workbench, and related population health tools.
Key Responsibilities
Architecture & Technical Leadership
- Own the end-to-end solutions architecture for Epic Healthy Planet, care coordination workflows, and STARS/HEDIS/quality measure reporting
- Design scalable data models and workflows connecting Epic Clarity/Caboodle, Healthy Planet registries, care management, and risk stratification tools to STARS and quality reporting needs
- Serve as the technical authority on Epic's population health suite (Healthy Planet, Care Everywhere, Home Health, ACO-specific tools) and its integration with clinical, claims, and payer data sources
- Partner with enterprise architecture and data teams to ensure Epic solutions align with broader data governance, interoperability (FHIR/HL7), and analytics strategy
- Evaluate and recommend build vs. buy decisions for third-party STARS/quality vendors integrating with Epic
STARS & Quality Reporting
- Lead the design and optimization of Epic-based workflows supporting CMS Star Ratings, HEDIS measures, and quality gap closure
- Ensure Epic build accurately supports care gap identification, outreach workflows, and measure-specific documentation requirements
- Partner with quality, risk adjustment, and compliance teams to translate regulatory measure specifications (NCQA, CMS) into Epic build requirements
- Oversee reporting architecture (Reporting Workbench, SlicerDicer, Clarity/Caboodle-based reporting) to support STARS performance tracking and executive dashboards
Care Coordination / Healthy Planet
- Architect and oversee build for care management workflows: registries, care plans, risk stratification, transitions of care, and care team communication
- Ensure Healthy Planet configuration supports ACO, MA, and population health program requirements
- Drive integration between Healthy Planet and external care coordination platforms, HIEs, and payer systems
Leadership & Governance
- Lead and mentor a team of Epic analysts, architects, and/or engineers focused on population health applications
- Partner with clinical, quality, compliance, and network/ACO leadership to align technical roadmap with business strategy
- Present architecture decisions, risks, and roadmap to senior IT and business leadership
- Participate in Epic governance, upgrade planning, and enterprise architecture review boards
- Manage vendor relationships related to STARS/quality reporting tools and population health platforms
Required Qualifications
- Bachelor's degree in Computer Science, Health Informatics, Information Systems, or related field (Master's preferred)
- 10+ years of healthcare IT experience, with 5+ years focused on Epic applications
- Deep hands-on or architectural experience with Epic Healthy Planet, Care Everywhere, and/or population health modules
- Strong understanding of CMS STARS methodology, HEDIS measures, and quality/risk adjustment reporting requirements
- Experience architecting solutions involving Clarity, Caboodle, and/or Epic reporting tools
- Proven track record leading enterprise-scale Epic initiatives and managing technical teams
- Strong understanding of value-based care, ACO operations, and payer-provider data exchange
Preferred Qualifications
- Epic certification(s) in Healthy Planet, Ambulatory, or related modules
- Experience with FHIR/HL7 interoperability standards and payer data integration
- Background working within an integrated payer-provider organization or ACO
- Experience with Medicare Advantage plan operations
- Advanced degree or certifications in health informatics, data architecture, or population health
Key Competencies
- Translates complex regulatory/quality requirements into practical technical architecture
- Strong executive presence; able to communicate technical trade-offs to non-technical leadership
- Balances long-term architectural vision with near-term delivery pressures
- Skilled at leading cross-functional teams spanning clinical, quality, compliance, and IT
Pay Range
The typical pay range for this role is:
$100,000.00 - $231,540.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
