CareFirst Careers

Stars & Risk Adjustment Analyst

Resp & Qualifications

PURPOSE
Interprets Stars rating data; analyzes HEDIS, CAHPS and Stars results using statistical techniques; and provides ongoing reports.  Executes quantitative analyses that translate data into actionable insights.  Provides analytical and data-driven decision-making support for key projects.

ESSENTIAL FUNCTIONS
Collect, analyze, and interpret Stars data to glean insights, and develop business recommendations for improvement.

Develops and automates reports, solving for the Business Intelligence (BI) and analytical needs of full range of stakeholders. Works with stakeholders to establish the right metrics for monitoring the business.

Uses the latest CMS & NCQA requirements and works with stakeholders and engineering colleagues to help deliver data driven solutions.

Communicates findings on a regular basis to all levels of business and management.

Reviews reports and performance indicators to improve quality and Stars ratings.

Sets standards for data management and conceives projects needed to eliminate the gap between current state and future goals. Assists in defining and driving standards for data management and delivers projects needed to eliminate the gap between current state and future goals.


QUALIFICATIONS:
Education Level: Bachelor's Degree
Education Details: Data Science, Mathematics, Computer Science, Statistics, Business or related field
Experience: 2 years of experience in a quantitative role,

Preferred Qualifications
Hands on experience with Big Data/NoSQL Platforms with experience delivering production projects at scale.
Experience with HEDIS, CAHPS, and Stars

Knowledge, Skills and Abilities (KSAs)
Strong quantitative and qualitative skills.
Knowledge and understanding of analytical tools, such as SAS, Excel, SQL.
Excellent communication skills both written and verbal
Ability to learn quickly and take direction.

Additional Skills and Abilities
Proven track record of turning data into meaningful analysis, presenting to business stakeholders, and driving value for the business. Ability to see the big picture and to focus on details when necessary. Advanced knowledge and experience in topics of data and information management.

 

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Department

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

PeopleSoft/Self Service/Recruiting

Closing Date

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

 

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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