Medicare Advantage Stars SME - Data & Quality Leader

Medisolv, Inc.; Maryland; Hybrid; USD 120,000 - 150,000; Full time

Job summary

Medisolv, Inc. seeks a Medicare Advantage Stars Subject Matter Expert to bridge CMS requirements with technology and analytics.

You will translate complex CMS rules into product and data needs, collaborate with product managers, data scientists, and engineers, and help health plans improve Star Ratings through data-driven strategies. The role demands deep MA Stars knowledge, strong analytical abilities, and ability to communicate with executives, quality leaders, and technical teams.

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 across health plans, healthcare tech, or consulting.
• Strong understanding of CMS MA Stars measures, methodology, regulations, and quality improvement.

Responsibilities

• Interpret CMS MA and Part D Stars regulations, technical specifications, and guidance.
• Define business and functional requirements for MA Stars tech and analytics products.
• Engage with MA health plans to understand Stars strategies and data environments.
• Analyze MA quality data to evaluate measure performance and trends.
• Lead cross-functional teams to ensure regulatory accuracy in product designs.

Skills

CMS MA Stars knowledge

Analytical skills

Regulatory interpretation

Communication

Education

Bachelor's degree

Tools

SQL

Data warehouses

BI tools

Job description

Medisolv, Inc. seeks a Medicare Advantage Stars Subject Matter Expert to bridge CMS requirements with technology and analytics.

You will translate complex CMS rules into product and data needs, collaborate with product managers, data scientists, and engineers, and help health plans improve Star Ratings through data-driven strategies. The role demands deep MA Stars knowledge, strong analytical abilities, and ability to communicate with executives, quality leaders, and technical teams.