About the position
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Performs and leads various advance analysis and interpretation to business activities for process improvements that will impact membership retention and overall STAR rating. Handles large and complex internal and external data initiatives, lead as subject matter expert in all things related to CMS voluntary disenrollment insights. Leads annual CMS STAR rating disenrollment compliant audits, providing examples of any gaps that could change our Medicare STAR rating by H-contract. Able to interpret and understand changes to voluntary disenrollment logics according to CMS requirements. Leads in the support of business initiatives through CMS STAR rating trend analysis via TRR, identification of membership reasons for disenrollment and recommend opportunities for process improvement in retention planning. Present findings in PowerPoint format for leadership. Provides advanced insight and dashboard development support for business leaderships in the following areas: CMS disenrollment (TRR, crosswalk, competitor directories), membership, sales channel, product type/space, regional/state level, H-contract/PBP level datasets with advance Excel, Tableau, and Power-BI tools. Provides development of annual STAR voluntary disenrollment rating forecast down to each PBP level to provide guidelines/resources needed to blend the curve and achieve higher STAR ranking for higher CMS bonus. Oversees training and mentoring other business and data analysts both internal and external to the team. Serve as the subject matter expert in all things related to CMS STAR rating disenrollment analysis.
Responsibilities
- Perform and lead various advanced analysis and interpretation to business activities for process improvements impacting membership retention and overall STAR rating.
- Handle large and complex internal and external data initiatives.
- Lead as subject matter expert in all things related to CMS voluntary disenrollment insights.
- Lead annual CMS STAR rating disenrollment compliant audits.
- Interpret and understand changes to voluntary disenrollment logics according to CMS requirements.
- Support business initiatives through CMS STAR rating trend analysis via TRR.
- Identify membership reasons for disenrollment and recommend opportunities for process improvement in retention planning.
- Present findings in PowerPoint format for leadership.
- Provide advanced insight and dashboard development support for business leaderships.
- Develop annual STAR voluntary disenrollment rating forecast down to each PBP level.
- Oversee training and mentoring of other business and data analysts.
Requirements
- Bachelor's degree in related field or equivalent experience.
- 8+ years of statistical analysis or data analysis experience.
- Healthcare experience preferred.
- Experience performing CMS Plan Finder 'member choosing to leave plan' Star measure audit.
- Experience managing projects or heavy involvement in project implementation.
- Advanced MS Excel and MS PowerPoint skills.
- Ability to understand SQL and SAS queries.
- Ability to modify Tableau/Power BI dashboards.
Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
