Business Intelligence Lead - Hedis Preventive
About The Position
The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations. In this pivotal role, you will provide analytical expertise and strategic insights that drive our Stars program success. Your work will directly support leadership decision-making and the advancement of Stars improvement efforts. This is an exciting opportunity for a seasoned professional to influence outcomes that improve member health, enhance plan quality and drive organizational growth.
Requirements
- Bachelor's degree
- 7 or more years of technical experience in data analysis
- 3+ years of experience in Medicare Advantage, Stars programs or healthcare analytics
- Strong understanding of CMS Star Ratings and Medicare Advantage programs
- Experience with tools such as Tableau, SQL, Power BI and/or QlikView
- Advanced experience working with big and complex data sets within large organizations
- Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
- Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
- Excellent communication and presentation skills, with the ability to convey complex concepts clearly to senior leadership
Nice To Haves
- Experience with payer claims data
- Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field
- Advanced in SQL, SAS and other data systems
- Experience with tools such as Tableau and Qlik for creating data visualizations
- Expertise in data mining, forecasting, simulation, and/or predictive modeling
- Experience creating analytics solutions for various healthcare sectors
Responsibilities
- Analyze the impact of member growth, retention and movement on Star Ratings working with claims, clinical and quality data.
- Develop insights that inform business strategies and operational improvements to support Star Rating goals.
- Interpret complex data to evaluate program nuances and their implications on performance.
- Prepare high-quality, data-driven materials for VP and senior leadership discussions.
- Participate in strategic conversations, providing actionable insights and recommendations.
- Communicate complex analytical findings in a clear and compelling manner to non-technical audiences.
- Collaborate with cross-functional teams to assess and enhance Stars performance.
- Act as a subject matter expert, explaining the intricacies of Stars methodology and metrics.
- Create executive-level dashboards and presentations that showcase key metrics, trends and improvement opportunities.
- Ensure data accuracy, consistency and clarity in all reporting and analysis.
- Use your skills to make an impact.
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- many other opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Senior
