Medicare Stars Analyst

What We Need

As a core member of the Government Programs Star Performance team, the Medicare Stars Analyst provides ongoing analytic support to the development and execution of the health plan's best in class 5-star strategy. In collaboration with the VP, Medicare Stars, this person will work with key stakeholders from across the company, e.g. performance measurement and improvement, clinical quality, operations, and pharmacy, to identify opportunities for improvement and measures of success in the pursuit of continuous quality improvement of our Medicare stars ratings.

The successful candidate will have an established track record of identifying and executing data driven solutions across a myriad of projects, including but not limited to, clinical quality, member satisfaction, and operational excellence.

Day-to-Day

• Works with Stars Performance leadership and stakeholders from across the organization to analyze root causes driving poor Star performance and propose data driven solutions that facilitate improvement.
• Provide subject matter expertise of the CMS Star Rating methodology, and act as a resource when methodological questions arise.
• Develops targeted recommendations to inform effective member and provider outreach strategies to improve health care outcomes and consumer experience among Medicare population.
• Generates and tests working hypotheses: aggregate and mine data, conduct analyses, and extract actionable results.
• Develop analytic dashboards to track performance of access to care, clinical quality and consumer experience metrics and to predict the performance trending in Medicare population.
• Partners with technical teams to design and improve Medicare data intake and storage infrastructure to enable efficient analytics.
• Prepares and presents analysis results to internal decision-makers, often creating informative business metrics to influence decision makers.

What We're Looking For

• A deep understanding of the CMS Star rating methodology with experience working across all measurement domains including clinical performance, member experience, and operations.
• Experience mapping business needs to analytics planning and technical requirements.
• Experience in working with large structured and unstructured data sets.
• Demonstrable knowledge of, and practical experience in applying advanced analytics, and methodologies to support business decision making.
• Ability to independently execute projects with multiple business stakeholders on firm deadlines.
• Ability to identify opportunities to enhance productivity, increase efficiency, simplicity, and add measurable tangible and intangible values.
• Strong teamwork and ability to solve data and analytics problems through communication and collaboration.
• Data analytics experience a must; strong technical skills in programming with SAS, R, Python or other tools.
• Excellent written and verbal communication skills, with the ability to clearly and concisely present issues, analytical planning, and recommendations in verbal, written and presentation formats across all levels of the organization.

What You Bring

• Five (5) or more years of healthcare experience, with at least 2 years working on Center for Medicare and Medicaid (CMS) Stars programs, National Committee for Quality Assurance (NCQA) programs, and Healthcare Effectiveness and Data Information Set (HEDIS) management and analysis.
• Understanding of Stars measures, financial impact and interpretation of results, weighting and cut points to enable Stars measure improvements.
• Strong teamwork and ability to solve data and analytics problems through communication and collaboration.
• Bachelor's degree in statistics, applied math, or related field is required. Advanced degree (MA/MS or PhD) is a plus.
• Experience in applying advanced analytics to improve population health, care management, and consumer experience.

This position is eligible for the Flex persona.

#LI-HYBRID

High school degree or equivalent required unless otherwise noted above

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that theconfidence gapandimposter syndromecan prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting ourCompany Culturepage. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join ourTalent Communityto stay "in the know" on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.