Medicare Stars & Quality Program Analyst

📋 Description

• Assist in the analytics activities of the Capital Medicare Advantage Star Ratings Program that influence program strategy and operations.

• Work collaboratively with internal stakeholders and teams to implement action plans based on performance and forecast data.

• Create and sustain dashboards and performance tracking tools using Power BI and Excel to facilitate ongoing monitoring and executive reporting.

• Evaluate Medicare STARS performance metrics, such as HEDIS, CAHPS, HOS, and operational measures, to uncover trends, gaps, and opportunities.

• Lead or assist in forecasting STARS ratings by leveraging historical data, predictive modeling, and CMS methodologies to estimate future performance.

• Write and refine SQL queries to extract, manipulate, and analyze complex datasets from various origins.

• Utilize Python for automating data processing tasks, producing forecasts, and performing advanced analyses as necessary.

⛳️ Requirements

• Over 3 years of experience in a Medicare Advantage environment, with at least 2 years dedicated to STARS performance management.

• Proficient in Python, SQL, MS Access, Excel, SAS, Power BI, and other querying/reporting tools.

• Solid understanding of CMS STARS methodology, including HEDIS, CAHPS, HOS, and operational measures.

• Proven experience in forecasting STARS performance, preferably using data models and predictive analytics.

• Experience in vendor management, project management, and/or quality improvement.

🏝️ Benefits

• Medical, Dental & Vision coverage

• Retirement Plan

• Generous time off including Paid Time Off, Holidays, and Volunteer time off

• Incentive Plan

• Tuition Reimbursement