Stars Population Health Measure Optimization Lead

The Stars Population Health Business Intelligence Lead will help the team move from reporting activity to generating actionable intelligence. Success in this role will be reflected in stronger population visibility, clearer performance accountability, faster identification of improvement opportunities, more rigorous evaluation of initiatives, and better-informed decisions that support Stars performance and member health outcomes.

Health Quality and Stars (HQS) is responsible for improving health outcomes and advancing the care experience of members and provider partners through quality solutions. HQS is committed to caring for customers and delivering high plan quality as rated by the Centers for Medicare & Medicaid Services (CMS).

The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans across measures that include preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.

The Stars Population Health Business Intelligence Lead will provide advanced analytics, population insights, and reporting capabilities that enable the Stars Population Health Strategy team to improve performance among priority populations. The role will translate complex data into a clear understanding of performance drivers, member needs, program effectiveness, and opportunities for action across unpaneled members, new members, multi-gap members, and the Annual Preventive Visit enterprise strategy.

This role will partner across Stars and the enterprise to strengthen data availability, define meaningful performance measures, monitor outcomes, and create decision-ready insights. The role requires both deep technical expertise and strong business judgment, with the ability to influence stakeholders, establish shared accountability, and connect analytics directly to population-specific strategy and execution.

• Analyze member-level Stars, demographic, engagement, program, and operational data to identify performance drivers, emerging trends, and opportunities within priority populations.

• Develop code, reports, dashboards, and repeatable analytical capabilities that support population strategy, initiative performance monitoring, and executive decision-making.

• Create clear data visualizations, executive summaries, and strategic narratives for immediate colleagues, enterprise partners, and senior leadership.

• Collate and manipulate data from multiple sources, including Oracle, SQL, Excel, and enterprise reporting environments, while documenting available data, dependencies, quality considerations, and gaps.

• Build population definitions, segmentation approaches, baselines, targets, and measurement frameworks for unpaneled members, new members, Pragmatic Planner segments, multi-gap members, and Annual Preventive Visit performance.

• Conduct Stars performance and demographic analyses across relevant perspectives such as geography, contract, product, measure, member segment, intervention, and channel.

• Own deep, holistic operational reporting for priority initiatives and provide regular executive-level rollups that clarify performance, risks, opportunities, and recommended actions.

• Measure initiative effectiveness and member outcomes, identify what is and is not working, and recommend strategy adjustments based on evidence.

• Monitor performance of critical populations within existing programs and assess how outreach and engagement efforts can be better coordinated to reduce unnecessary touchpoints and improve effectiveness.

• Use forecasting, scenario analysis, and predictive techniques, where appropriate, to estimate opportunity, prioritize focus areas, and support resource…