Medicare Advantage Stars Data Analyst

Medisolv•Clarksville, MD

About The Position

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.

Requirements

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

Nice To Haves

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

Responsibilities

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 reporting specifications and dashboards that turn complex data into actionable insight for plan leaders
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
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
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
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