Stella Onuoha-Obilor
Wexford,PA
Summary
Delivering exceptional leadership and strategic vision to enhance clinical outcomes and drive affordable healthcare. Accomplished and seasoned quality and clinical risk management leader with expertise in process development, clinical quality, NCQA Accreditation, quality data analytics, and leading teams through member strategies and intervention development. Drive improvements in health outcomes and healthcare management through extensive experience and expertise in quality, safety, and results-driven goal achievement. Adept at driving efficiency, process improvement, and effective talent management to create significant shifts in clinical outcomes and operational scalability. Design and launch processes, programs, evidence-based practices, and policies that improve Medicare STARS, CAHPS, HEDIS, and HOS scores. Serve organizations as an SME in leveraging talent development and growth strategies to enhance patient outcomes. Focused on utilizing data-driven metrics to create actionable solutions that improve clinical performance, mitigate risk, and cultivate world-class healthcare operations.
Overview
8
8
years of professional experience
1
1
Certification
Work History
VP, Clinical Quality & Population Health
HIGHMARK HEALTH
Pittsburgh, PA
01.2020 - 01.2024
- Joined the organization to design and lead a comprehensive Quality, Safety, & Value strategy that effectively aligned organizational goals, regulatory standards, and population health priorities
- Leveraged care and utilization management expertise with data-driven analytics to drive enterprise-wide performance improvement and evidence-based practices across the enterprise and provider networks
- Ensured compliance with NCQA, HEDIS, CMS, and state regulations while advancing the Clinical Data Strategy with a focus on interoperability and AI-driven data acquisition
- Managed cross-functional teams, leading internal & external audits, clinical services, and staff development
- Had strategic oversight of HEDIS operations for all markets and products, including setting strategies for maximizing STAR ratings, recognizing withheld dollars, and reporting
- Provided leadership to achieve target improvement goals
- Drove a full-cycle talent management process to support the development, growth, and retention of high-quality clinical teams, including implementing an effective onboarding process and creating an environment of open communication to prevent attrition and reduce turnover rates proactively
- Partnered with leaders across all business functions to align strategies and objectives, creating streamlined approaches to meeting business objectives, clinical metrics, and client expectations
- Architected and launched healthcare initiatives and clinical programs that elevate the patient experience and clinical outcomes
- Delivered success in achieving top Medicare Star ratings, including 3 PA plans with 5 Stars from CMS for 5 consecutive years, and played a pivotal role in securing Delaware’s Medicare Advantage PPO’s first-ever 4-star rating
- Executed a strategic Care and Utilization Management Audit, resulting in $2.4MM in cost savings and enhancing financial efficiency with a 0.25 PMPM incremental savings
- Transformed NY quality of care operations, saving 1,292 hours (~$101k annually) and safeguarding $130MM in Medicare STARs revenue by leading a critical HEDIS data migration
- Spearheaded preventive health initiatives that elevated care quality and consistently met and exceeded accreditation standards
- Ensured financial and operational integrity by overseeing the retrieval and review of 69,000 medical records, achieving 100% audit validation, and avoiding $10.5MM in penalties through innovative tracking tools
- Redesigned departmental structures to ensure sustainable, high-quality coverage for 7.5MM members, significantly improving the efficiency of utilization and case management
- Revitalized NCQA accreditation programs by championing a shift to person-centered care and capitalizing on real-time data for continuous quality improvement
- Utilized data-driven metrics to advance the performance of quality objectives and patient care services, designing and implementing scorecards to rapidly establish best practices and areas of opportunity
Senior Director - Measures Management Department & Chief Clinical Transformation Officer
NEW JERSEY INNOVATIVE INSTITUTE
Newark, NJ
01.2018 - 01.2019
- Recruited to the organization to leverage expertise in data-driven analytics and clinical strategies to design and deploy strategic initiatives for Value-Based Programs, including MIPS, ACO, and Medicare Quality, driving alignment with business goals and CIN initiatives
- Championed complex contracts, budgets, and resource utilization while supporting business development and securing grant opportunities
- Mentored, coached, and led 500+ professionals across 10 hospital systems, generating $150MM in cost savings and successfully engaging 10K practices through a $50MM CMS grant-funded Practice Transformation and Clinically Integrated Network initiative
- Built and launched dashboards and scorecards in collaboration with the analytics team, leading to improved transparency in clinical performance, increased ability to track and trend data, and enhanced QM performance
- Leveraged data-driven metrics derived from the Measures Manager Tool to effectively close care gaps and identify areas of opportunity, yielding quantifiable improvements in patient outcomes
- Spearheaded the transition to ACO, CIN, and Patient-Centered Medical Home (PCMH) care models, facilitating a seamless adoption and aligned strategy with value-based care objectives
Senior Manager – Quality Management & Performance Improvement
VISITING NURSE SERVICE OF NEW YORK – CHOICE HEALTH PLAN
Brooklyn, NY
01.2016 - 01.2018
- Appointed to lead the organization in diverse quality initiatives spanning Medicaid, Medicare Advantage, MLTC, and Special Needs Programs, developing strategies to enhance member care and improve performance metrics such as HEDIS/QARR and Medicare Star ratings
- Designed and launched quality improvement projects, managed QM Committees, and ensured alignment with CMS Triple Aim goals
- Focused on analyzing data-driven metrics and delivering actionable solutions based on trends and metrics, continuously advancing service quality and operational efficiency
- Championed a quality improvement initiative that delivered a 5% reduction in patient readmission rates in under 6 months
- Optimized quality of care processes, reducing talent by 3k hours annually without hindering service
- Fostered a culture of talent engagement, professional development, and collaboration, effectively reducing turnover by 50%
- Implemented standardized SBARs to overcome a backlog of Utilization Management cases, slashing by 50% in under 6 weeks
Education
DOCTOR OF PUBLIC HEALTH - POPULATION HEALTH MANAGEMENT, HEALTHCARE ADMINISTRATION, & HEALTH POLICY
Walden University
MASTER OF PUBLIC HEALTH - POPULATION MANAGEMENT
Walden University
DOCTOR OF MEDICINE -
UNIVERSITY OF CALABAR MEDICAL SCHOOL
NIGERIAASSOCIATE OF SCIENCE - NURSING (RN)
Excelsior University
EXECUTIVE LEADERSHIP PROGRAM -
Wharton
Measurement, Design & Analysis - Health Outcomes Research
Harvard University
Skills
- Strategic Planning & Execution
- NCQA Accreditation
- HEDIS
- Medicare STARS
- Clinical Program Development
- Talent Engagement & Growth
- Continuous Learning Environment
- Change Management
- Risk Adjustment
- Value-Based Care
- Cost Reduction
- Risk Mitigation
- Member Experience
- Patient-Centered Operations
- Continuous Process Improvement
- Performance Metrics
- KPIs
- Executive Communication
- Data-Driven Analytics
- Population Health Strategy
- Healthcare Operations Leader
- QA Programs
- Initiatives
- Regulatory Compliance
- Medicare Advantage Program
- Medicaid
- Dual Eligible
- Continuum of Care Expertise
- Commercial
- ACA
- CHIP
- LTC
- EP
- Quality management
- Data analysis
- Visionary leadership
- Administrative support
- Human resources management
- Solution innovation
- Multitasking Abilities
- International business
- Financial administration
- Client engagement
- Coaching and mentoring
- Business strategy
- Talent recruitment
- Board reporting
- Negotiation and persuasion
- Staff management
- Business consulting
- Sales growth
- Financial leadership
- Develop business structures
- Risk management
- Strategic business planning
- Performance data analysis
- Resource allocation
- Annual planning
- Supply chain management
- Team collaboration
- Organizational development
- Multitasking
- Employee engagement
- Operations oversight
- Corporate communications
- Human resources
- Program oversight
- Interpersonal communication
- Expense reporting
- Board collaboration
- Technical support
- Approachable leader
- Management team leadership
- Interpersonal skills
- Adaptability and flexibility
- Analytical thinking
- Training and development
- Schedule management
- Brand management
- Business administration
- Verbal and written communication
- New business development
- Scheduling
- Performance metrics analysis
- Corporate governance
- Market trends and analysis
- Active listening
- Policies and procedures
- Problem-solving
- Market analysis
- Regulatory compliance
- Care management
- Performance improvement
- Financial analysis
- Project management
- Team leadership
- Stakeholder engagement
- Clinical program development
- Operational efficiency
- Patient-centered care
- Talent development
- Interdepartmental collaboration
- Continuous improvement
- Crisis communication
- Industry best practices
- Business planning
- Digital marketing
- Product development
- Revenue growth
- Innovative and visionary
- Client relationship management
- Quality control planning
- Budgeting and cost control
Certification
- Fellow American College of Healthcare Executives (FACHE)
- Certified Case Manager (CCM)
- Certified Professional in Healthcare Quality (CPHQ)
- Lean Six Sigma Healthcare Black Belt (LSSBB)
- Lean Six Sigma Healthcare Green Belt (LSSGB)
Approach To Work
I am committed to empowering teams, embracing innovation, and delivering transformative healthcare solutions by fostering collaboration, cultivating talent, and driving measurable outcomes that improve lives and communities.
Awards Affiliations
- Beckers Hospital Review | Recognized as an Influential Black Healthcare Leader in the US
- American College of Healthcare Executives | Member
- Case Management Society of America | Member
- American Public Health Association | Member
- Bronx Community Health Network | Board Member
- Community Human Services of Pittsburgh | Board Member
- African Youth Movement United Nations Chapter | President
Timeline
VP, Clinical Quality & Population Health
HIGHMARK HEALTH
01.2020 - 01.2024
Senior Director - Measures Management Department & Chief Clinical Transformation Officer
NEW JERSEY INNOVATIVE INSTITUTE
01.2018 - 01.2019
Senior Manager – Quality Management & Performance Improvement
VISITING NURSE SERVICE OF NEW YORK – CHOICE HEALTH PLAN
01.2016 - 01.2018
DOCTOR OF PUBLIC HEALTH - POPULATION HEALTH MANAGEMENT, HEALTHCARE ADMINISTRATION, & HEALTH POLICY
Walden University
MASTER OF PUBLIC HEALTH - POPULATION MANAGEMENT
Walden University
DOCTOR OF MEDICINE -
UNIVERSITY OF CALABAR MEDICAL SCHOOL
ASSOCIATE OF SCIENCE - NURSING (RN)
Excelsior University
EXECUTIVE LEADERSHIP PROGRAM -
Wharton
Measurement, Design & Analysis - Health Outcomes Research
Harvard University