We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
The Solution Architect, Epic STARS is responsible for the design, optimization, and strategic direction of Epic-based solutions supporting Medicare Star Ratings, HEDIS, and NCQA quality measure performance. This role bridges clinical quality strategy and technical Epic build, ensuring that quality measure workflows, data capture, and reporting infrastructure within Epic Healthy Planet and related modules accurately support Star Ratings improvement initiatives across the organization. The ideal candidate combines deep Epic technical expertise with a strong understanding of value-based care, population health, and quality measurement methodologies.
Key Responsibilities
Solution Architecture & Design
- Architect and design Epic Healthy Planet, Reporting Workbench, Clarity/Caboodle, and SlicerDicer solutions to support Medicare Star Ratings, HEDIS, and NCQA measure tracking and gap closure.
- Translate quality measure specifications (CMS Star Ratings, HEDIS technical specifications, NCQA requirements) into functional and technical Epic build requirements.
- Design scalable data models and reporting frameworks that support accurate, auditable quality measure calculation and Star Ratings performance monitoring.
- Own the end-to-end technical roadmap for Epic STARS-related builds, including registries, care gap alerts, best practice advisories (BPAs), and health maintenance topics tied to Star measures.
Stakeholder Partnership & Strategy
- Partner with Quality, Population Health, ACO, and clinical leadership to understand measure priorities and translate business needs into Epic solutions.
- Serve as the primary technical liaison between clinical quality teams and Epic build/development teams for all Star Ratings initiatives.
- Collaborate with data analytics and reporting teams to ensure quality measure data feeds are accurate, timely, and aligned with CMS submission requirements.
- Present architectural recommendations, risk assessments, and solution options to senior leadership and governance committees.
Build, Delivery & Optimization
- Lead or oversee Epic build activities related to Star Ratings measures, including registries, health maintenance plans, documentation flowsheets, and quality dashboards.
- Evaluate existing Epic workflows for gaps in quality measure capture and recommend workflow or build optimizations to improve Star performance.
- Ensure interoperability between Epic and external quality reporting platforms or vendor tools (e.g., HEDIS engines, risk adjustment vendors) using FHIR/HL7 standards where applicable.
- Conduct testing, validation, and troubleshooting of quality measure logic to ensure accuracy of Star Ratings-related reporting.
Governance, Compliance & Documentation
- Maintain thorough documentation of Epic STARS architecture, data flows, and build decisions to support audit readiness and knowledge continuity.
- Ensure solutions comply with CMS, NCQA, and internal data governance standards.
- Participate in change control and release management processes for all Star Ratings-related Epic builds.
Innovation & Continuous Improvement
- Stay current on CMS Star Ratings methodology changes, HEDIS specification updates, and Epic Healthy Planet roadmap enhancements.
- Identify opportunities to leverage new Epic functionality (e.g., predictive models, care gap automation) to improve Star Ratings outcomes.
- Mentor junior analysts and build staff on Epic quality measure architecture best practices.
Required Qualifications
- Bachelor's degree in Health Informatics, Information Systems, Computer Science, or related field (or equivalent experience).
- 5+ years of experience with Epic, including hands-on work in Healthy Planet, Clarity/Caboodle, Reporting Workbench, or SlicerDicer.
- Demonstrated experience supporting Medicare Star Ratings, HEDIS, and/or NCQA quality measure programs.
- Strong understanding of value-based care and ACO population health operations.
- Epic certification(s) in Healthy Planet or Reporting Cadence, ClinDoc, or related modules strongly preferred.
- Experience translating clinical/quality specifications into technical build requirements.
- Familiarity with FHIR/HL7 interoperability standards.
Preferred Qualifications
- Experience with agile delivery tools (e.g., Rally) for managing build backlogs and release planning.
- Prior experience in a health plan, ACO, or integrated delivery network environment.
- Knowledge of risk adjustment and quality reporting vendor platforms.
- Strong presentation and stakeholder management skills, with experience briefing senior leadership.
Key Competencies
- Technical depth balanced with strategic, big-picture thinking
- Strong cross-functional collaboration across IT, clinical, and quality teams
- Analytical rigor and attention to detail in measure logic and data validation
- Clear written and verbal communication of complex technical concepts to non-technical stakeholders
Pay Range
The typical pay range for this role is:
$106,605.00 - $284,280.00
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.
Skills Required
- Bachelor's degree in Health Informatics, Information Systems, Computer Science, or a related field, or equivalent experience
- 5+ years of experience with Epic, including hands-on experience with Healthy Planet, Clarity/Caboodle, Reporting Workbench, or SlicerDicer
- Experience supporting Medicare Star Ratings, HEDIS, and/or NCQA quality programs
- Strong understanding of value-based care and ACO population health operations
- Experience translating clinical and quality specifications into technical build requirements
- Familiarity with FHIR and HL7 interoperability standards
- Epic certification in Healthy Planet, Reporting Cadence, ClinDoc, or related modules
- Experience with agile delivery tools such as Rally for build backlogs and release planning
- Experience in a health plan, ACO, or integrated delivery network environment
- Knowledge of risk adjustment and quality reporting vendor platforms
- Strong presentation and stakeholder management skills, including experience briefing senior leadership
CVS Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about CVS Health and has not been reviewed or approved by CVS Health.
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Healthcare Strength — Health coverage includes medical, dental, and vision with HSA-eligible options, free preventive care, virtual care, and access to MinuteClinic services. Mental-health resources such as counseling support are emphasized, and coverage is often considered solid for full-time colleagues.
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Retirement Support — A dollar-for-dollar 401(k) match up to 5% after one year and an Employee Stock Purchase Plan are consistently highlighted in Total Rewards materials. Feedback suggests retirement programs are a meaningful strength within the overall package.
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Wellbeing & Lifestyle Benefits — Wellbeing offerings include up to 20 no-cost counseling sessions per issue, backup care, tuition assistance, and substantial in-store discounts, alongside broader wellness tools. These everyday perks expand value beyond base pay and can be especially meaningful for full-time schedules.
CVS Health Insights
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
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