Medicare Advantage Stars Data Analyst

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Description

Who We Are

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.

About the Role

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.

What You'll Do

Medicare Advantage Stars Data Expertise

• 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

Data Ingestion & Data Management

• 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

Data Marts & Analytical Models

• 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

Data Analysis & Reporting

• 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

Business Intelligence & Visualization

• 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

Health Plan Collaboration

• 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

Data Quality & Validation

• 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

Product Development & Cross-Functional Collaboration

• 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

What You'll Accomplish - Your Performance Objectives

In your first 30 days, you will:

Onboard and get to know the people, product, and data platform. Build foundational knowledge of CMS Stars measures and methodology, the underlying data sources (claims, HEDIS, CAHPS, HOS, supplemental data, etc.), and how data flows from source systems through the data warehouse into Stars reporting. Begin shadowing data ingestion, validation, and reporting work already underway.

In your first 60 days, you will:

Take on ownership of specific data validation, reconciliation, or reporting tasks within an active Stars data workstream, with support from data engineering and Stars SMEs. Begin contributing to data mapping specifications, dashboard builds, or analytical datasets under guidance.

In your first 90 days, you will:

Independently own a Stars data product or reporting deliverable end-to-end - from source data and mapping through validation to a finished dashboard or analysis - and begin working directly with health plan stakeholders to interpret results and identify opportunities for improvement.

Who We're Looking For - The Competencies That Matter

Required

• Bachelor's degree in data analytics, computer science, health informatics, healthcare administration, mathematics, statistics, business, or a related field
• 5 plus 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

Preferred

• Experience working for a Medicare Advantage health plan, healthcare technology company, consulting organization, or Stars analytics vendor
• Experience with Stars-specific data marts, CMS Stars data submissions, reports, technical specifications, or methodology
• Experience with HEDIS, CAHPS, HOS, claims, encounters, pharmacy, enrollment, provider, supplemental, and other MA data sources
• Experience with ETL/ELT pipelines and cloud data platforms (Snowflake, Databricks, Azure, AWS, or similar)
• Experience with data visualization and dashboard development in Power BI or Tableau, and familiarity with healthcare data standards and common MA data structures
• Experience working in Agile product environments, collaborating with software engineers and data engineering teams to build production data products

How to Be a Medisolver - Our Values

• Customer Success Obsession
• All-Star Team Collaboration
• Continuous Improvement through Curiosity & Data-Driven Learning
• Courage with Kindness
• Execution Focus - We Do Business, Not Just Talk Business

Medisolv is committed to creating a diverse and inclusive workplace. We believe that diversity drives innovation, and we are dedicated to fostering an environment where all employees feel valued and respected.

All candidates must successfully pass a pre-employment background check and be legally authorized to work in the United States. Sponsorship is not available.