Medicare Advantage Stars SME & Analytics Lead

Medisolv Inc; Clarksville (MD); On-site; USD 140,000 - 190,000; Full time

Job summary

Medisolv Inc. is seeking a Medicare Advantage Stars SME to bridge CMS regulations with product development. You will translate star-rating requirements into data specs and collaborate with analytics, engineering, and sales to advance MA quality initiatives. This role demands strong domain knowledge and ability to communicate complex ideas clearly.

You will engage with health plans, analyze performance data, and influence product roadmaps to improve star performance and reporting accuracy.

Qualifications

• Bachelor's degree in healthcare administration, public health, business, data analytics, health informatics, nursing, or a related field.
• 5+ years of experience with Medicare Advantage Stars and CMS quality programs at a health plan or healthcare technology company.
• Strong understanding of CMS MA Stars measures, methodology, regulations, and quality improvement programs.
• Excellent written and verbal communication across executives, quality leaders, product managers, analysts, engineers, and developers.
• Ability to translate regulatory and technical documents into practical business and technology requirements.

Responsibilities

• Interpret CMS MA Stars regulations, technical specifications, and guidance for internal teams.
• Define business and functional requirements for MA Stars technology and analytics products.
• Collaborate with product managers, data scientists, and engineers to ensure regulatory accuracy.
• Engage with MA health plans to understand Stars strategies and data environments.
• Present Stars findings to executives and stakeholders.

Skills

MA Stars knowledge

CMS quality programs

Analytical skills

Regulatory interpretation

Cross-functional communication

Education

Bachelor's degree in healthcare administration

BS in data analytics or related field

Tools

SQL

Data warehouses

BI tools

Job description

Medisolv Inc. is seeking a Medicare Advantage Stars SME to bridge CMS regulations with product development. You will translate star-rating requirements into data specs and collaborate with analytics, engineering, and sales to advance MA quality initiatives. This role demands strong domain knowledge and ability to communicate complex ideas clearly.

You will engage with health plans, analyze performance data, and influence product roadmaps to improve star performance and reporting accuracy.