Manager, Data Analytics – Medicare Advantage Stars REMOTE or Hybrid

Blue Cross Blue Shield of Michigan; United States; Remote; USD 92,000 - 155,000; Full time

Job summary

A leading healthcare provider is seeking a Manager of Data Analytics for overseeing Medicare Advantage Stars initiatives. This remote/hybrid role involves optimizing analytics operations, ensuring compliance with regulations, and enhancing performance metrics. The ideal candidate will have extensive experience in healthcare data, strong leadership abilities, and a commitment to continuous improvement.

Qualifications

• Seven (7) years of relevant experience required.
• Three (3) years supervisory experience needed.
• Certification or progress towards it is preferred.

Responsibilities

• Manage day-to-day Stars analytics operations and develop models.
• Ensure compliance with CMS Stars regulations.
• Supervise exempt and non-exempt staff effectively.

Skills

Data programming languages (Python, SAS, SQL)

Project management

Healthcare data knowledge

Analytical skills

Team collaboration

Education

Bachelor’s degree in a related field

Master’s degree preferred

Tools

Databricks

MS SQL

Excel

Job description

Manager, Data Analytics – Medicare Advantage Stars REMOTE or Hybrid

United States (Remote)

Job Description

The Manager, Star Rating Data & Analytics will oversee activities in support of Star Rating data management including Star Rating generation, oversight of the vendor, collaboration with IT teams, and Star Analytics support. This position is responsible to plan, organize, direct, control, and lead the assigned business unit.

RESPONSIBILITIES/TASKS:

• Manages Stars analytics day-to-day operations, developing & refining models to optimize performance and adapt to evolving data needs
• Manages activities of a department including, but not limited to, planning, problem solving, staff development, and communication.
• Collaborate with teams to translate analytic insights into impactful improvements across all Stars measures and cross-metric analysis
• Monitors CMS Stars regulations year-round, ensuring compliance and adapting strategies to maintain accurate Star Ratings programs
• Executes function/area objectives that support continuous improvement.
• Manages professional, exempt, and non-exempt non-bargaining and bargaining unit employees.
• Responsible for special projects and/or problem resolutions.
• Provides effective and efficient solutions to complex business problems.
• Provides high level oversight and leadership.
• Drives Stars analytics projects from start to finish, aligning them with business goals and coordinating stakeholder involvement.
• Responsible for balancing workload to optimize the effectiveness of the department.

DIRECTION EXERCISED:

Directly supervises exempt and non-exempt staff in accordance with company policies and applicable Federal and State Laws. Responsibilities include, but are not limited to, effectively interviewing, hiring, terminating, and training employees; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EDUCATION:

Bachelor’s degree in a related field. Master’s degree in a related field preferred. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company’s learning philosophy, is required.Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Seven (7) years experience of progressive responsibility in a related environment with demonstrated technical knowledge that provides the necessary knowledge, skills, and abilities required. Three (3) years supervisory or lead experience in related field required.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Proficient with databases like Databricks, MS SQL, etc. and data applications.
• Proficient in data programming languages such as Python, SAS and/or SQL
• Proficient in current industry standard PC applications and systems (e.g., Excel and Word)
• Experience with Medicare Advantage, CMS Star Ratings, and pharmacy analytics required
• Knowledge and experience with healthcare data and knowledge of industry standard data models
• Knowledge and understanding of architecture, application design, and integration
• Strong project management skills, including leading cross-functional initiatives
• Ability to work in a general direction.
• Ability to work effectively in a team environment.
• Excellent analytical, organizational, planning, verbal, and written communication skills.
• Other related skills and/or abilities may be required to perform this job.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
• Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.
• Ability to work with and empower others on a collaborative basis to ensure success of unit team.
• Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques.
• Ability to establish workflows, manage multiple projects, and meet necessary deadlines.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. Travel may be required.

PAY RANGE:

Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $92,200 and $154,500