Medicare STAR Business Technologist

Job Number: 1915

Workplace Type:

Position Title: Medicare STAR Business Technologist

External Description:

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.

Accountabilities:

In collaboration with the Sr. Medicare STAR Data Analyst:

1. Performs complex analysis of the data.
2. Research, analyze, and interpret statistical data and provides technical assistance to other staff.
3. Acts as a resource for other members within AHC on business issues and may be responsible for training and guidance of other employees.
4. Investigates opportunities for expanded data collection that are needed elements for CMS Star Rating Measures.
5. Independently manages the retrieval and analysis of data, and issues that may arise on multiple tasks or projects with limited management involvement.
6. Support of Medicare Stars business initiatives that drive short- and long-term objectives towards achieving the overall 5 Star goal.
7. Designs and conducts analyses and outcome studies using healthcare claims, pharmacy and lab data, employing appropriate research designs and statistical methods.
8. Develops, validates and executes algorithms that answer applied research and business questions.

Required Qualifications:

1. 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.
2. Demonstrated analytic and problem-solving skills.
3. Proficiency in Microsoft software applications such as Word, PowerPoint, Excel, Access.
4. Demonstrated ability to design, evaluate and interpret complex data sets.
5. Demonstrated ability to handle multiple tasks with competing priorities.
6. 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.
7. Demonstrated ability to work effectively both independently and in a team setting with individuals having diverse professional backgrounds including business, technical and/or clinical.

Preferred Qualifications:

1. Knowledge of health care performance measurement; CMS STAR ratings strongly preferred.
2. Basic knowledge of SQL and SAS.
3. 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.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Medicare STAR Business Technologist

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].