Lead Data Analyst, Medicare Stars & Quality Analytics

Experteer Overview In this senior analytics role, you will lead complex healthcare analyses supporting Medicare Stars, provider incentive and quality programs, and enterprise reporting. You will partner with cross-functional teams to identify improvement opportunities, build targeted outreach and ROI analyses, and deliver impactful dashboards and insights. You’ll shape performance initiatives and contribute to plan outcomes through data-driven decision making. This is a chance to influence star ratings and provider performance at scale. Compensation / Benefits * Independently design and execute complex analyses for Medicare Stars, provider incentive programs, quality improvement initiatives, and enterprise reporting * Develop member targeting and outreach lists using criteria, measure-level gap information, claims data, and member attributes * Evaluate ROI of outreach, engagement, and quality programs * Analyze CMS Star Ratings, measure performance, and market benchmarks for improvement opportunities * Perform provider performance and pay-for-performance analyses to support incentives and reporting * Develop, maintain, and enhance dashboards and reporting solutions using Power BI and other tools * Write, optimize, and validate complex SQL queries with CTEs, window functions, and joins * Integrate, validate, and analyze data from multiple healthcare sources (claims, enrollment, provider, pharmacy, clinical, HEDIS, CMS) * Partner with stakeholders to gather requirements, translate needs into analytical solutions, and deliver actionable insights * Communicate findings to technical and non-technical audiences while ensuring reporting accuracy and integrity Tasks * 5-7 years of experience in healthcare analytics, data analysis, reporting, or related field * Ability to independently lead complex analytical projects with minimal supervision * Strong SQL querying skills (complex joins, window functions, CTEs, large datasets) * Experience developing dashboards and reporting with Power BI * Experience with healthcare claims, membership, provider, and clinical data * Experience performing root cause analysis and translating findings into recommendations * Experience supporting UAT testing and validating outputs * Advanced Microsoft Excel skills Key requirements *

_ opportunities * Perform provider performance and pay-for-performance analyses to support incentives and reporting * Develop, maintain, and enhance dashboards and reporting solutions using Power BI and other tools * Write, optimize, and validate complex SQL queries with CTEs, window functions, and joins * Integrate, validate, and analyze data from multiple healthcare sources (claims, enrollment, provider, pharmacy, clinical, HEDIS, CMS) * Partner with stakeholders to gather requirements, translate needs into analytical solutions, and deliver actionable insights * Communicate findings to technical and non-technical audiences while ensuring reporting accuracy and integrity Tasks * 5-7 years of experience in healthcare analytics, data analysis, reporting, or related field * Ability to independently lead complex analytical projects with minimal supervision * Strong SQL querying skills (complex joins, window functions, CTEs, large datasets) * Experience developing dashboards and reporting with Power BI * Experience with healthcare claims, membership, provider, and clinical data * Experience performing root cause analysis and translating findings into recommendations * Experience supporting UAT testing and validating outputs * Advanced Microsoft Excel skills Key requirements *