Address
Form of workEmployment TypeFull-time
Exempt or Non-ExemptExempt
Job Summary
Minimum Qualifications
Duties and Responsibilities
Exempt or Non-ExemptExempt
Job Summary
**Hybrid Work Environment - Must reside in Hawaii **
Serves as a lead Business Data Analyst to inform initiatives and strategy within the Medicare Stars team. Works independently to monitor Medicare Star Ratings program performance at the plan and measure level and manages all aspects of Stars performance data: identification, synthesis of disparate sources, analysis, management, reporting and visualization. Supports efforts with internal and external partners by providing relevant and actionable data.
Minimum Qualifications
- Bachelor's degree and five years of related work experience; or equivalent combination of education and related work experience.
- Demonstrated knowledge in identifying issues, collecting data, and analyzing and interpreting data.
- Intermediate working knowledge of Microsoft Office applications including Word, PowerPoint and Outlook.
- Advanced working knowledge of Microsoft Excel.
- Advanced working knowledge of MicroStrategy, SQL, SAS, Access, R or other business intelligence language/tools.
- Intermediate working knowledge of Tableau or other data visualization tools.
Duties and Responsibilities
- Research and Analysis:
- Proactively develops, implements and/or enhances methods to extract complex data sets from available sources (e.g., HMSA data repositories, HEDIS software, external party extracts, etc.).
- Integrates data and uses advanced analytical methods/tools to identify business-critical trends, issues, root causes and focused population segments.Translates data into actionable visualizations using tables, graphs, charts, written reports and presentations.
- Works closely with management to develop short and long-term departmental objectives.
- Synthesizes data insights and stakeholder input to provide recommendations to internal and external partners to support Stars performance improvement initiatives.
- Applies expert understanding of standard quality measures (e.g., HEDIS, CAHPS, HOS) to identify additional strategic improvement levers (e.g., supplemental data, benefit alignment) that may impact Stars performance.
- Ensures Stars measure data is complete and accurate by implementing effective controls and validation activities.
- Cross-Functional Collaboration
- Participates in and contributes to various projects and cross-departmental teams that support the Stars program. Prioritizes Stars performance data needs across efforts.
- Serves as the lead Stars performance data subject matter expert in various workgroups and efforts (e.g., data strategies, HEDIS performance, provider performance platforms such as Coreo, etc.). Writes business requirements and test scripts, performs unit and system testing.
- Coordinates Stars performance data activities with related quality team activities (e.g., HEDIS data team, Payment Transformation quality team, FQHC/RHC quality team). Coordinates Stars improvement activities with the HCC risk adjustment team to ensure integration and alignment of quality goals with HCC risk adjustment objectives.
- Represents HMSA in Blues plan and/or other industry work groups to compare best practices for improving Stars performance data.
- Stars Performance Monitoring
- Maintains a high-level understanding of the Medicare Part C & D Star Ratings Technical Notes. Monitor proposed changes, proactively identify potential risks to Stars performance, as well as associated mitigation strategies.
- Gathers data to create and publish the Stars dashboard and related metrics on a monthly basis. Proactively identifies and supports acquisition of new data sources.
- Distributes actionable data to facilitate Stars performance monitoring against current targets and year-end projections.
- Works with internal and external teams to proactively identify and implement Stars dashboard enhancements.
- Validates CMS Stars plan performance reports (e.g., First Plan Preview, Westat MCAHPS reports) against internal data.
- Other Duties/Functions
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid
