Gather, research, and document requirements from business stakeholders. Design, develop, implement, and maintain new deliverables, processes, or models. Responsible for operationalizing regulatory and/or business requirements, including process improvement and work related to growth initiatives.
Key Accountabilities
Create Data Programs to Support CMS (Centers for Medicare & Medicaid Services) Star Rating Reporting
- This position will oversee and assist the Stars Program Leader with tracking the CMS (Centers for Medicare & Medicaid Services) Star Ratings Program at the measure level.
- The position will proactively identify, analyze, manage, and report data and trends that enable the Stars team to make course corrections and employ strategies to achieve program goals.
- Create and maintain databases utilized to develop reporting and visualizations to support data-driven decision making by the Stars team and division leaders.
- Process cleanse company data and third-party sources of information, and verify the integrity of the data used for analysis.
- Identify additional strategic improvement levers that may impact quality outcomes, such as supplemental data, benefit alignment, and anticipate the final impact of improvement initiatives to assist in strategic deployment of improvement tactics.
Work cross-functionally and externally with needed parties to obtain data and provide actionable data reporting.
- Organize and maintain databases with data joined across multiple sources.
- Identify data sources, both internal and external, to aid in dashboard and reporting development.
- Analyze external and internal data using database queries, spreadsheet (Excel) models, third-party analytics tools, and statistical analysis tools.
- Model and frame business scenarios that are meaningful and which impact critical issues and help navigate process improvements and decisions.
- Provide actionable customer, provider, and division data insights to address key strategic questions by assessing, evaluating, and continually reporting on progress towards CMS Stars measures and impact goals.
Support Enterprise Stars Strategy
- Serve as data subject matter expert for CMS, HEDIS, Part D, and CAHPS/HOS data.
- Maintain strategic relationships and partner with key resources, internally and externally, to support the Stars program.
- Manage and monitor multiple appropriate metrics, perform data analysis and evaluation for each initiative.
- Manage multiple communication plans in coordination with leadership and to support initiatives, including status and progress updates.
- Support regulatory and contractual CMS (Centers for Medicare and Medicaid Services) Stars requirements for the organization.
Qualifications
- Bachelor's degree or equivalent experience in a related field.
- 5+ years of related professional experience in business management, technology, mathematics, business administration, or related fields.
- Experience using data extraction tools and data modeling preferred.
Skills and Abilities
- Strong critical thinking skills and problem-solving/conflict resolution skills.
- Excellent written and verbal communication skills with strong facilitation and presentation skills, adapting approach as needed.
- Attention to detail and time management skills.
- Self-motivated, ability to work independently, and demonstrated ability to work under tight time frames.
- Ability to work in a team environment.
- Knowledge of the health care industry.
- Proven ability to handle various assignments in a fast-paced and complex business environment.
- Proven problem-solving skills; ability to collect and analyze data, draw relevant conclusions, and devise appropriate courses of action.
- Previous CMS Stars experience.
This position is a Remote role. The employee must be located in any state in which Medica is an employer and will work remotely 100% of the time.
The full salary range for this position is $75,300 - $129,000. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity, and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services, and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.
Recruiter: Carissa Hammer
Medica's commitment to diversity, equity, and inclusion (DEI) includes unifying our workforce through learning and development, recruitment, and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent, and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
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