Job Details

Medicare Advantage Data Analyst

The primary focus of this role is to support Star Ratings projection modeling and analytics for Medicare Advantage. The Data Analyst will work with large datasets to generate insights, perform ad-hoc analyses, and assist in monitoring key performance indicators related to CMS Star Ratings.

Responsibilities/Tasks:

• Supports Stars projections through data analysis, modeling scenarios & ensuring accurate Star Ratings forecasts
• Monitors CMS regulations & incorporates policy updates, ensuring accurate Stars projection model maintenance.
• Utilizes software tools and programming to query & manipulate Star metrics data for accurate reporting & analytics.
• Develops and improves workflows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality.
• Identifies and/or analyzes business problems and devise procedures for solutions to the problems.
• Effectively leads projects in order to produce desired results.
• Responsible for corporate communication of project results.
• Recommends and assists with implementing standard policies and procedures.
• Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis.
• Participates in systems testing, develops procedures/controls, and provides recommendations for the ongoing improvement of the updated process.
• Assists personnel (both internal and external) by answering questions, supplying information, and training.
• Develops and maintains an effective working relationship with customers.
• Participates in group or committee discussions.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

Education: Bachelor's degree in a related field. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged. Experience may be accepted in lieu of degree.

Experience: Two (2) to four (4) years experience in related field. Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.

Skills/Knowledge/Abilities (SKA) Required:

• Analytical, organizational, planning and problem solving skills
• Proficiency in Excel, VBA, SQL, SAS and Python required
• Experience with Tableau /PowerBi or similar data visualization tools
• Healthcare industry experience, particularly Medicare Advantage or CMS Star Ratings, strongly preferred
• Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies
• Ability to plan, organize, direct, and control projects.
• Excellent written and verbal communication skills.
• Ability to lead and contribute to process improvement projects.
• Ability to read and interpret documents such as data flows, process flows, technical diagrams, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Ability to speak effectively before groups of customers or employees of organization.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables in standardized situations.
• Administer and adhere to corporate and departmental policies, practices and procedures.

Working Conditions: Work is performed in an office setting with no unusual hazards.

Pay Range: Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $62,000 and $103,700.