Description

You will manage Medicare STARS performance analysis and forecasting to drive strategic outcomes.

Responsibilities

• Analyze Medicare STARS performance metrics, including HEDIS, CAHPS, HOOS, and operational measures, to identify trends and gaps.
• Lead forecasting of STARS ratings using historical data, predictive modeling, and CMS methodology.
• Translate forecast insights into strategic initiatives to optimize performance and achieve target ratings.
• Collaborate with Quality, Clinical, Operations, IT, and Compliance teams to execute action plans.
• Develop and maintain performance tracking dashboards in Power BI and Excel.
• Write and optimize SQL queries to extract and manipulate complex datasets.
• Automate data processing and conduct advanced analyses using Python.
• Support audits, internal reviews, and CMS data submissions to ensure data integrity.

Required Skills

• 5+ years of professional experience.
• Strong understanding of CMS STARS methodology, including HEDIS, CAHPS, and HOOS.
• Proven experience forecasting STARS performance using data models and predictive analytics.
• Proficiency in SQL for data extraction and manipulation.
• Proficiency in Python for automation and advanced analysis.
• Proficiency in Power BI and Excel for visualization and reporting.
• Experience working within a Medicare Advantage setting.
• Bachelor's degree in Health Administration, Business, Data Analytics, Public Health, or a related field.

Key Skills

Education

Any Graduate