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Blue Cross Blue Shield of Massachusetts · 3 hours ago

Medicare Stars Analyst

Boston, MA

Full-time

Hybrid

Mid, Senior Level

$92K/yr - $112K/yr

5+ years exp

Blue Cross Blue Shield of Massachusetts is seeking a Medicare Stars Analyst to support their Government Programs Star Performance team. The role involves analyzing data to improve Medicare stars ratings and collaborating with various stakeholders to enhance healthcare outcomes.

AssociationCommunitiesHealth InsuranceInsuranceMedicalNon Profit

H1B Sponsor Likely

Responsibilities

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

Qualification

CMS Star Rating methodologyData analytics experienceAdvanced analyticsProgramming with SASProgramming with RProgramming with PythonHealthcare experienceTeamworkCommunication skillsProblem-solving

Required

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

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

Bachelor's degree in statistics, applied math, or related field is required

Preferred

Advanced degree (MA/MS or PhD) is a plus

Experience in applying advanced analytics to improve population health, care management, and consumer experience

Benefits

Paid time off

Medical/dental/vision insurance

401(k)

A suite of well-being benefits

Company

Blue Cross Blue Shield of Massachusetts

Glassdoor3.4

Blue Cross Blue Shield of Massachusetts is a state licensed private health insurance company

Founded in 1937

Boston, Massachusetts, USA

1001-5000 employees

https://www.bluecrossma.org

H1B Sponsorship

Blue Cross Blue Shield of Massachusetts has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (11)

2024 (21)

2023 (8)

2021 (2)

2020 (6)