Healthcare Medicare STARS Analyst

About the Role:

We are seeking a highly analytical and business-savvy Healthcare Medicare STARS Analyst to join our team. This role requires strong domain expertise in Medicare Advantage STARS programs, coupled with hands-on experience in forecasting STARS performance and applying data-driven strategies to improve outcomes. The ideal candidate will also have foundational technical skills in Power BI, SQL, Python, and Excel to support advanced reporting and predictive analysis.

Key Responsibilities:

• Analyze Medicare STARS performance metrics including HEDIS, CAHPS, HOS, and operational measures to identify trends, gaps, and opportunities.
• Lead or contribute to the forecasting of STARS ratings, using historical data, predictive modelling, and CMS methodology to project future performance.
• Translate STARS forecast insights into strategic initiatives to optimize performance and achieve targeted ratings.
• Collaborate with internal teams (Quality, Clinical, Operations, IT, and Compliance) to drive action plans based on performance and forecast data.
• Develop and maintain dashboards and performance tracking tools in Power BI and Excel to support ongoing monitoring and executive reporting.
• Write and optimize SQL queries to extract, manipulate, and analyse complex datasets from various sources.
• Use Python for automating data processing tasks, generating forecasts, and conducting advanced analyses as needed.
• Ensure accurate, timely reporting and alignment with evolving CMS requirements and regulatory updates.
• Support audits, internal reviews, and CMS data submissions with high attention to data quality and integrity.

Required Qualifications:

• Bachelor's degree in Health Administration, Business, Data Analytics, Public Health, or a related field.
• 3+ years of experience working in a Medicare Advantage setting, with a minimum of 2 years focused on STARS performance management.
• Strong understanding of CMS STARS methodology, including HEDIS, CAHPS, HOS, and operational measures.
• Demonstrated experience with forecasting STARS performance, ideally using data models and predictive analytics.
• Proficiency with Python, SQL, Power BI and Excel Skills for visualization and report creation.

Originally posted on Himalayas