Blue Cross Blue Shield of Massachusetts
Medicare Stars Analyst
Blue Cross Blue Shield of Massachusetts, Boston, Massachusetts, us, 02298
Ready to help us transform healthcare? Bring your true colors to blue.
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—including 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.
We are looking for a candidate with an established track record of identifying and executing data‑driven solutions across a wide range 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.
Provides subject‑matter expertise of the CMS Star Rating methodology and serves 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 the Medicare population.
Generates and tests working hypotheses: aggregates and mines data, conducts analyses, and extracts actionable results.
Builds analytic dashboards to track performance of access to care, clinical quality, and consumer experience metrics and predicts performance trends in the 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 stakeholders.
What We're Looking For
Deep understanding of the CMS Star rating methodology with experience across all measurement domains, including clinical performance, member experience, and operations.
Experience mapping business needs to analytics planning and technical requirements.
Experience 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, simplify processes, and add measurable tangible and intangible value.
Strong teamwork and communication skills to solve data and analytics problems collaboratively.
Data analytics experience required; 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 plans, and recommendations across all levels of the organization.
What You Bring
Five (5) or more years of healthcare experience, including at least 2 years on Center for Medicare and Medicaid (CMS) Stars programs, National Committee for Quality Assurance (NCQA) programs, and Healthcare Effectiveness Data and Information Set (HEDIS) analysis.
Understanding of Stars measures, financial impact, and interpretation of results, including weighting and cut points to enable Stars measure improvements.
Bachelor’s degree in statistics, applied mathematics, or a related field is required; an advanced degree (MA/MS or PhD) is a plus.
Experience applying advanced analytics to improve population health, care management, and consumer experience.
This position is eligible for the Flex persona.
Minimum Education Requirements: High school degree or equivalent, unless otherwise noted above.
Location: Boston
Time Type: Full time
Salary Range: $91,890.00 – $112,310.00
We offer a comprehensive benefits package including paid time off, medical/dental/vision insurance, 401(k), and a suite of well‑being benefits to eligible employees.
We are committed to investing in your development and providing the resources to enable your success. Learn more about our inclusive workplace culture on our Company Culture page. If you are interested, apply now or join our Talent Community to stay informed about our opportunities.
#J-18808-Ljbffr
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—including 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.
We are looking for a candidate with an established track record of identifying and executing data‑driven solutions across a wide range 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.
Provides subject‑matter expertise of the CMS Star Rating methodology and serves 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 the Medicare population.
Generates and tests working hypotheses: aggregates and mines data, conducts analyses, and extracts actionable results.
Builds analytic dashboards to track performance of access to care, clinical quality, and consumer experience metrics and predicts performance trends in the 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 stakeholders.
What We're Looking For
Deep understanding of the CMS Star rating methodology with experience across all measurement domains, including clinical performance, member experience, and operations.
Experience mapping business needs to analytics planning and technical requirements.
Experience 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, simplify processes, and add measurable tangible and intangible value.
Strong teamwork and communication skills to solve data and analytics problems collaboratively.
Data analytics experience required; 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 plans, and recommendations across all levels of the organization.
What You Bring
Five (5) or more years of healthcare experience, including at least 2 years on Center for Medicare and Medicaid (CMS) Stars programs, National Committee for Quality Assurance (NCQA) programs, and Healthcare Effectiveness Data and Information Set (HEDIS) analysis.
Understanding of Stars measures, financial impact, and interpretation of results, including weighting and cut points to enable Stars measure improvements.
Bachelor’s degree in statistics, applied mathematics, or a related field is required; an advanced degree (MA/MS or PhD) is a plus.
Experience applying advanced analytics to improve population health, care management, and consumer experience.
This position is eligible for the Flex persona.
Minimum Education Requirements: High school degree or equivalent, unless otherwise noted above.
Location: Boston
Time Type: Full time
Salary Range: $91,890.00 – $112,310.00
We offer a comprehensive benefits package including paid time off, medical/dental/vision insurance, 401(k), and a suite of well‑being benefits to eligible employees.
We are committed to investing in your development and providing the resources to enable your success. Learn more about our inclusive workplace culture on our Company Culture page. If you are interested, apply now or join our Talent Community to stay informed about our opportunities.
#J-18808-Ljbffr