Medicare Stars Senior Analytics Consultant

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About the role

The Medicare Stars Senior Analytics Consultant will lead the analytics strategy for evaluating internal and external program initiatives within the Medicare Stars program. This position is located within the Medicare Stars Analytics team, which provides operational and analytical support to internal and external partners to improve HCSC’s Medicare Star Ratings.

The Senior Analytics Consultant will develop data analyses using pharmacy claims, clinical outcomes, and Stars quality measures to make recommendations based on findings. Responsibilities include building a framework to analyze performance of external vendors and internal groups, creating reports and dashboards to monitor performance, and using advanced analytics techniques to identify root causes of issues.

This role interfaces across multiple business areas, including pharmacy, clinical, customer experience, product development, and operations. Reports and dashboards will be used by business partners and Stars leadership to make critical decisions related to program enhancements, new pilots, and opportunities to maximize Stars affordability and enterprise value.

The ideal candidate will have a passion for healthcare analytics and a creative mindset for approaching data in innovative ways.

Responsibilities

• Lead analytics strategy for Medicare Stars program initiatives.
• Develop data analyses using pharmacy claims, clinical outcomes, and Stars quality measures.
• Build frameworks to analyze performance of external vendors and internal groups.
• Create reports and dashboards to monitor performance on an ongoing basis.
• Use advanced analytics techniques to identify root causes of issues.
• Interface with multiple business areas (pharmacy, clinical, customer experience, product development, operations).
• Provide actionable insights to business partners and Stars leadership for decision-making.
• Champion initiatives and collaborate with stakeholders to drive execution.
• Deliver high-quality output to senior leadership under tight deadlines.

Requirements

• Bachelor's degree and 6 years of experience in healthcare services, statistical analysis, insurance industry economics, or related field; OR
• Master’s degree with 4 years of experience in the same fields; OR
• PhD with 2 years of experience in the same fields; OR
• 10 years of experience in the same fields.
• Proficiency in querying internal and external data sources for meaningful insights.
• Strong analytical skills and expertise in languages such as SQL, Python, or R.
• Ability to create dynamic, visually engaging dashboards using tools like Tableau or Power BI.
• Business intelligence skills to drive a business case from inception to execution.
• Experience leading analytic initiatives to success.
• Excellent communication and presentation skills.
• Ability to work independently and as part of a team.
• Performance excellence in collaborating with stakeholders to bring initiatives to life.
• Ability to work under pressure and deliver high-quality output within short timelines.
• Experience with version control/collaborative tools, such as GitHub.

Preferred Qualifications

• Experience with project management methodologies.
• Healthcare industry experience (payor, provider, pharmacy, public health, epidemiology).
• Knowledge of the CMS Star Rating System, including HEDIS, Pharmacy, Administrative, and CAHPS Measures.
• Extensive experience with medical claims, pharmacy claims, customer eligibility, and customer experience/self-report data.
• Ability to translate business operations requirements into technical applications.
• Strong interpersonal and customer service skills, with proven ability to perform in a matrix environment.
• Leadership and project management skills.
• Ability to work autonomously and deal with ambiguity.
• Experience with automation tools, such as Alteryx or Airflow.

Schedule

This is a Flex (Hybrid) role: 3 days in office, 2 days work from home.

Pay

Compensation: $84,400.00 - $152,300.00. Exact compensation may vary based on skills, experience, and location.