Develop and maintain standardized Stars and Risk Adjustment reporting using internal data sources and CMS files within Databricks and Power BI
Lead code development and end-user dashboard creation, applying subject-matter expertise to meet defined business needs
Serve as a subject matter expert on Risk Adjustment data sources, including MAO-004, 837, MMR, and MOR files
Present internal overviews and detailed analytical findings to stakeholders to ensure alignment and clarity on next steps
Analyze data to identify trends, performance opportunities and develop actions plans to address gaps
Build a deep understanding of clinical workflows and collaborate to enhance processes that support departmental efficiency and effectiveness
Partner with internal teams to share insights that may influence underwriting, contracting, operations and other business areas
Support the growth of direct and matrixed team members by fostering knowledge‑sharing and sustainable progress toward departmental goals

Bachelor’s degree required; Master’s degree in healthcare or a related field, or actuarial certification (FSA/ASA in progress of completed) preferred
Minimum of two (2) years of experience in Medicare Advantage Stars or Risk Adjustment analytics
Proficiency in SQL, R, and Python; experience working with large enterprise data warehouses; strong ability to build, modify and optimize data tables; intermediate-to-advanced Power BI skills, including complex DAX and data modeling
Knowledge of CMS Risk Adjustment and Stars data sources (MAO-004, 837, MMR, MOR)
Ability to translate data into clear, actionable insights
Communication skills and ability to collaborate in a matrixed environment and influence others to drive outcomes

Comprehensive Benefits
Medical, dental, and vision insurance
employee assistance program
employer-paid and voluntary life insurance
disability insurance
plus health and flexible spending accounts
Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts

Senior Analyst, Medical Economics, Stars and Risk Adjustment

Key skills