Medicare Advantage Stars Data Analyst

Description

Healthcare quality is complex. Medisolv helps make it manageable - and actionable.

We partner with hospitals, health systems, ACOs, and payers to bring clarity to quality data, connecting clinical and claims information into a single, reliable view. More than 1,800 organizations and 130M+ patient records rely on Medisolv to measure, report, and improve performance across 500+ measures tied to CMS, The Joint Commission, and other programs.

With support from Bessemer Venture Partners Forge, we're continuing to grow our platform and expand our impact - investing in advanced analytics, AI, and new capabilities that help healthcare organizations stay ahead of change and improve outcomes with confidence.

Reporting to the GM, Performance Intelligence, we are looking for an experienced Medicare Advantage Stars Data Analyst to join our team.

We are seeking a Medicare Advantage (MA) Stars Data Analyst with strong experience working with healthcare data and a deep understanding of the data underlying the CMS Medicare Advantage Star Ratings program.

This individual will be responsible for ingesting, organizing, analyzing, validating, and reporting Medicare Advantage Stars data, and will work closely with product, technology, analytics, and health plan teams to turn complex Stars data into actionable insights.

The ideal candidate combines strong data analytics and data engineering knowledge with practical Medicare Advantage Stars expertise - a data analyst first and a Stars expert second, equally comfortable writing SQL, troubleshooting a data feed, building a Power BI dashboard, and explaining a Stars calculation to a health plan's quality team. This is not simply a reporting role: the successful candidate understands how MA quality data flows from source systems through ingestion, transformation, and data marts into analytical models, dashboards, and ultimately Stars performance insights - and can translate a CMS Stars specification into a working data model, validate the results, and build something a health plan can act on.

The position will play a key role in building and maintaining data products that enable Medicare Advantage health plans to understand their Stars performance, identify opportunities for improvement, and make better quality and operational decisions.

• 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…