Medicare STAR Business Technologist
Location: Orange, California US
Job Number: 1915
Position Title: Medicare STAR Business Technologist
This position is responsible for supporting the CMS Star program improvements through data analysis. In collaboration with the Sr. Medicare STAR Data Analyst, analyze complex data and information to provide meaningful results, identifying success factors and improvement opportunities, and suggesting potential solutions. This position will leverage data from internal and external sources, understand relevant differences between each data source, and provide meaningful/actionable interpretation of results. This position will support the identification and development of databases to support business functions for the Medicare products, using enrollment, medical and pharmacy claims information.
This position will be supporting analytical projects in AHC’s Quality Improvement Medicare Stars team and will be responsible for conducting effectiveness studies on various program/campaigns to improve Stars Rating. Medicare stars team is engaged in all aspects of the analytic lifecycle from program ideation, financial support to the implementation and provides an open environment to identify/implement new studies. The individual in this position will take a lead in providing recommendations based on the analytic findings.
In collaboration with the Sr. Medicare STAR Data Analyst:
- Performs complex analysis of the data.
- Research, analyze, and interpret statistical data and provides technical assistance to other staff.
- Acts as a resource for other members within AHC on business issues and may be responsible for training and guidance of other employees.
- Investigates opportunities for expanded data collection that are needed elements for CMS Star Rating Measures.
- Independently manages the retrieval and analysis of data, and issues that may arise on multiple tasks or projects with limited management involvement.
- Support of Medicare Stars business initiatives that drive short- and long-term objectives towards achieving the overall 5 Star goal.
- Designs and conducts analyses and outcome studies using healthcare claims, pharmacy and lab data, employing appropriate research designs and statistical methods.
- Develops, validates and executes algorithms that answer applied research and business questions.
- Bachelor's degree in related field with 1-year healthcare or related job experience, or 5 years healthcare related experience in lieu of a degree.
- Demonstrated analytic and problem-solving skills.
- Proficiency in Microsoft software applications such as Word, PowerPoint, Excel, Access.
- Demonstrated ability to design, evaluate and interpret complex data sets.
- Demonstrated ability to handle multiple tasks with competing priorities.
- Excellent written and verbal communication skills and with an ability to interpret and communicate analytical information to both individuals and groups in a clear and concise manner.
- Demonstrated ability to work effectively both independently and in a team setting with individuals having diverse professional backgrounds including business, technical and/or clinical.
- Knowledge of health care performance measurement; CMS STAR ratings strongly preferred.
- Basic knowledge of SQL and SAS.
- Demonstrated ability to present complex technical information to non-technical audiences and to senior decision-makers.
The job description is not intended to be an exhaustive list of all functions and responsibilities of the position. Employees are held accountable for all the functions of the job. Job duties and the % of time identified for any function are subject to change at any time.
Location City: Orange
Location State: California
Community / Marketing Title: Medicare STAR Business Technologist
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.
We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.