Lead Quality/STARS Technical Analyst- remote - MediGold

Trinity Health Mid-Atlantic; Columbus (OH); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare organization is seeking a Lead Quality/STARS Technical Analyst to design and implement processes for data management and analysis. The role involves collaborating with teams to enhance quality performance and ensure compliance with CMS guidelines. Candidates should have a strong background in HEDIS, technical skills, and effective communication abilities. This position offers competitive salary and benefits, including medical coverage and retirement plans from day one.

Benefits

Medical, Dental, Vision from day one

Retirement plan with employer match

Paid time off

Tuition reimbursement

Employee Referral Rewards

DailyPay options

Qualifications

• Minimum of five years of HEDIS and technical experience.
• Thorough knowledge of NCQA and HEDIS required.

Responsibilities

• Develop and maintain production reporting capabilities.
• Provide statistical and analytical support using SAS, SQL.
• Create dashboards to monitor clinical quality and Medicare performance trends.

Skills

Communication

Collaboration

Analytical Skills

Education

Bachelor's Degree

Tools

SAS

SQL

Excel

Power BI

Tableau

Job description

Lead Quality/STARS Technical Analyst - remote - MediGold

Apply locations: Mount Carmel Corporate Services Center

Time type: Full time

Posted on: Posted 3 Days Ago

Requisition ID: 00589033

Employment Type:

Full time

Shift:

Day Shift

Description:

Successful candidates will possess at least 5 years of HEDIS and technical experience. A thorough understanding of NCQA and HEDIS is required. Knowledge of Medicare Stars—including CAHPS, HOS, Part D, and operational measures—is strongly preferred.

Why MediGold?

MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We’re dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.

About the job:

The Lead Quality/Stars HEDIS and Technical Analyst designs and implements processes and solutions for managing diverse data sets used in data mining, analysis, modeling, and prediction to support informed business decisions. Uses statistical analysis, querying, and reporting techniques to create solutions. Develops tools, algorithms, dashboards (Tableau), and queries to track and enhance quality and Stars performance. Collaborates with organization members to develop strategies for achieving a 5 Star rating and is responsible for report/dashboard creation, data verification, and QA in compliance with Plan requirements and CMS guidelines.

What we are looking for:

• Education: Bachelor's Degree required
• Experience: Minimum of five (5) years of HEDIS and technical experience
• Effective communication skills and ability to work collaboratively with multidisciplinary teams
• Knowledge of analytical tools such as SAS, Excel, SQL
• Experience with project execution and managing multiple assignments
• Mastery of relational database theory including SQL and at least one major RDBMS
• Familiarity with Big Data scenarios and applications
• Experience with analytics tools like Power BI and Tableau
• Thorough knowledge of NCQA and HEDIS
• Knowledge of Medicare Stars (CAHPS, HOS, Part D & Operational measures) strongly preferred

What you will do:

• Develop and maintain production reporting capabilities, ensuring timely and accurate report distribution
• Provide statistical and analytical support using SAS, SQL, SOURCE, and other software for data analysis
• Facilitate business requirements and define parameters for complex analytics projects
• Research and analyze healthcare cost and quality data for key business problems
• Create dashboards to monitor access to care, clinical quality, and consumer experience metrics, and predict Medicare performance trends
• Collaborate with technical teams to improve data infrastructure for analytics, ensuring compliance with CMS and NCQA requirements
• Interpret and report Star/HEDIS data, including executive summaries for plan and provider groups

Position Highlights and Benefits:

• Competitive salary and benefits, including medical, dental, vision from day one
• Retirement plan with employer match from day one
• Paid time off, employee recognition, tuition reimbursement, and relocation assistance
• Discounted tuition at Mount Carmel College of Nursing
• Employee Referral Rewards and DailyPay options
• Participation in Diversity, Equity, and Inclusion initiatives

Ministry/Facility Information:

Mount Carmel, part of Trinity Health, has served Central Ohio for over 135 years, with extensive facilities and programs. We promote a rewarding career focused on purpose and making a difference.

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Mount Carmel and affiliates are equal opportunity employers and do not discriminate based on protected classifications.

About Us

Trinity Health, one of the largest non-profit, Catholic healthcare systems, includes numerous hospitals and care facilities across 27 states, caring for diverse communities with a focus on mission-driven service.