Lead Quality/STARS Technical Analyst- remote - MediGold

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

Job summary

A leading healthcare organization seeks a Lead Quality/STARS Technical Analyst to manage data sets and enhance Medicare Stars performance. The role requires strong analytical skills and collaboration with various teams to ensure compliance and quality reporting. Candidates should have a Bachelor's degree and extensive experience with HEDIS and technical tools like SAS and SQL. This position offers competitive compensation and benefits from day one.

Benefits

Competitive compensation

Medical, dental, and vision coverage

Retirement plan with employer match

Paid time off

Tuition reimbursement

Relocation assistance

Employee Referral Rewards program

Access to DailyPay

Participation in Diversity, Equity, and Inclusion initiatives

Qualifications

• Minimum of five years of HEDIS and technical experience.
• Knowledge of analytical tools such as SAS, Excel, SQL.

Responsibilities

• Design and implement processes for managing diverse data sets.
• Develop tools and dashboards to enhance quality and Stars performance.
• Ensure compliance with CMS and NCQA requirements.

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

Join to apply for the Lead Quality/STARS Technical Analyst- remote - MediGold role at Trinity Health

Job Overview

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.

Employment Details

Type: Full time

Shift: Day Shift

About 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 various professional roles including IT, financial analysis, audit, provider relations, and more.

Job Responsibilities

• Design and implement processes and solutions for managing diverse data sets used in data mining, analysis, modeling, and prediction to support informed business decisions.
• Use statistical analysis, querying, and reporting techniques to create solutions.
• Develop tools, algorithms, dashboards (Tableau), and queries to track and enhance quality and Stars performance.
• Collaborate with organization teams to develop strategies for achieving a 5 Star rating.
• Responsible for report/dashboard creation, data verification, and QA in compliance with Plan requirements and CMS guidelines.

Qualifications

• Bachelor's Degree required.
• 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.
• Experience with Big Data scenarios and applications.
• Proficiency with analytics delivery tools like Power BI and Tableau.
• Thorough knowledge of NCQA and HEDIS; Medicare Stars knowledge preferred.

Key Responsibilities

• Develop and maintain production reporting capabilities, ensuring timely and accurate report distribution.
• Provide statistical and analytical support using SAS, SQL, SOURCE, and other software.
• Facilitate business requirements and define parameters for complex analytic projects.
• Research and analyze healthcare cost and quality data to address key business problems.
• Create dashboards to monitor access to care, clinical quality, and consumer experience metrics, and forecast Medicare performance trends.
• Partner with technical teams to improve Medicare data infrastructure.
• Ensure compliance with CMS and NCQA requirements for HEDIS rate production and reporting deadlines.
• Interpret and communicate Star/HEDIS reporting results, including executive summaries.

Benefits and Perks

• Competitive compensation, medical, dental, and vision coverage from day one.
• Retirement plan with employer match.
• Paid time off, employee recognition, tuition reimbursement, and relocation assistance.
• Discounted tuition at Mount Carmel College of Nursing.
• Employee Referral Rewards program.
• Access to DailyPay for daily wage viewing and transfer.
• Participation in Diversity, Equity, and Inclusion initiatives.

About Trinity Health

Trinity Health is a large not-for-profit Catholic healthcare system committed to diversity, equity, and inclusion, providing accessible and equitable care. We are proud to be an equal opportunity employer.