Medicare Advantage Stars Data Analyst

Medisolv Inc; Oregon; Hybrid; USD 110,000 - 150,000; Full time

Job summary

Medisolv Inc in the United States is seeking a Medicare Advantage Stars Data Analyst with deep healthcare data expertise. You will ingest, validate, and model data from claims, HEDIS, CAHPS, and other sources, turning complex Stars specifications into actionable insights for health plans.

You will build dashboards in Power BI/Tableau, design data marts, and work closely with product, technology, and plan stakeholders to improve Stars performance.

Qualifications

• Bachelor’s degree in data analytics, computer science, health informatics, healthcare administration, mathematics, statistics, business, or a related field.
• 5+ years of healthcare data experience, including direct work with Medicare Advantage Stars data and a strong understanding of CMS Stars measures and methodology.
• Experience with data ingestion, transformation, warehouses, marts, and analytical databases — including strong SQL skills and the ability to work from database schemas across multiple healthcare data sources.
• Experience developing reports and dashboards using Power BI, Tableau, or comparable BI tools.
• Strong data validation, reconciliation, and problem-solving skills.
• Ability to work directly with health plan stakeholders, translating business questions into analytical requirements, with strong communication skills for both technical and non-technical audiences.

Responsibilities

• Serve as the subject matter expert on CMS Stars measures, specifications, and methodology — including denominators, numerators, exclusions, benchmarks, and cut points.
• Understand how data from claims, HEDIS, CAHPS, HOS, supplemental feeds, and other sources is transformed into measure-level Stars performance.
• Track CMS methodology changes and help ensure analytical products stay aligned with them.
• Define data ingestion requirements with technical teams and map source data into standardized structures, specs, and data dictionaries.
• Identify and resolve data quality issues during ingestion, validating completeness, accuracy, and consistency.
• Understand and help monitor how data moves through ETL/ELT into warehouses, marts, and reporting layers.
• Design Stars data marts and analytical models, translating measure requirements into fact tables, dimensions, and calculated fields.
• Work from database schemas to model relationships between members, providers, claims, and quality events.
• Validate that data marts and models produce results consistent with CMS requirements and source data.
• Analyze Stars performance by plan, contract, measure, and provider — identifying trends, gaps, and anomalies.
• Perform year-over-year analysis of measure performance and Star Rating implications.
• Build reporting specifications and dashboards that turn complex data into actionable insight for plan leaders.
• Build and maintain dashboards using Power BI, Tableau, or similar platforms, ensuring they accurately reflect CMS methodology.
• Develop reusable measures, calculations, and visualizations rather than one-off analyses.
• Help define reporting standards and best practices for Stars analytics.
• Work directly with MA health plans to understand their data, reporting needs, and Stars analytics questions.
• Reconcile differences between internal plan reporting and external analytics, investigating discrepancies.
• Present analytical findings directly to plan quality, analytics, and business teams.
• Develop and execute data validation, reconciliation, and automated quality-check processes.
• Compare source, transformed, and reported data to investigate discrepancies or unexpected changes.
• Partner with engineering to resolve defects and validate new feeds or methodology changes.
• Partner with product, engineering, data science, and Stars SMEs to translate requirements into data specs, user stories, and test cases.
• Participate in product development from requirements through testing and deployment.
• Help automate manual processes and contribute to new Stars data products.
• In your first 30 days, on-board and get to know the people, product, and data platform.
• In your first 60 days, take on ownership of specific data validation, reconciliation, or reporting tasks within an active Stars data workstream.
• In your first 90 days, independently own a Stars data product or reporting deliverable end-to-end and begin working directly with health plan stakeholders to interpret results.

Skills

SQL

Power BI

Tableau

Data validation

Stakeholder communication

Analytical thinking

Education

Bachelor's degree in data analytics or related field

Tools

Snowflake

Databricks

Azure

AWS

ETL/ELT pipelines

Job description

Medisolv Inc in the United States is seeking a Medicare Advantage Stars Data Analyst with deep healthcare data expertise. You will ingest, validate, and model data from claims, HEDIS, CAHPS, and other sources, turning complex Stars specifications into actionable insights for health plans.

You will build dashboards in Power BI/Tableau, design data marts, and work closely with product, technology, and plan stakeholders to improve Stars performance.