Stars Analyst

Overview

The Stars Analyst works across the Cotiviti clientele to define, assign, and oversee best-in-class activities and Stars performance for all assigned Medicare Advantage plans. This individual is accountable for driving greater value and success for our customers by focusing on data, next best actions and maximizing member and provider outreach. They will also support identification of enhancements or improvements in the Cotiviti solutions to better support our clients.

The Stars Analyst will directly own and manage a small number of clients and is responsible to oversee all aspects of our engagement for our Stars, as well as HEDIS/Quality solution set. They will leverage their healthcare and project management knowledge in an effort to deliver the highest quality of services to Cotiviti clients.

Responsibilities

• Support the end-to-end Stars strategy, execution, and results across the assigned book of business
• Collaborates with regional and local health plan business leaders to improve overall Star ratings for their Medicare products
• Perform data and program management, included, but not limited to end-to-end data assessment to ensure accuracy in Stars measures
• Leads the organization to drive innovative initiatives that address low-performing measures
• Monitors historical and current data trends in order to make recommendations and predictions
• Inform and implement member centric health activation and provider network strategies to close gaps, improve outcomes and achieve results across Stars measures.
• Ensures program compliance and identifies opportunities to improve service and quality outcomes
• Act as the Cotiviti Stars program expert for both internal and external stakeholders
• Supports Stars-related quality initiatives and activities across multiple business lines
• Responsible for executing both national and market-specific strategies to ensure Stars success
• Aggregates Stars results and ongoing performance measures to senior and executive leadership
• Remains current and provides expertise around CMS Star measures, CAHPS, HOS guidelines
• Educates, advocates, and influences regulatory and policy organizations on behalf of Cotiviti
• Supports thought leadership publications around Stars and Medicare Advantage market
• Produces and manages documents related to client projects, calls, meetings, product specifications, special initiatives and follow up.
• Interacts directly with customers to drive client satisfaction and product adoption.
• Fully accountable for ensuring that open issues are managed in a timely manner and that no key milestones are missed.
• Responsible to track and report on client contractual SLA’s.
• Identify issues and obstacles that may hinder success and ensure the apprpriate Cotiviti resources are working to address these issues
• Complete all special projects and other duties as assigned.

Qualifications

• Five (5) or more years of healthcare experience, with at least 2 years working directly in Stars, CMS, NCQA, HEDIS
• Understanding of Stars measures, financial impact and interpretation of results, weighting and cut points to enable Stars measure improvements
• Experience in closing member quality gaps and provider outreach strategies
• Knowledge of regulatory quality-based reporting and audit requirements
• Proficiency in interpreting results and formulating recommendations/action plans
• Ability to research and analyze state/federal regulations related to health insurance and healthcare
• Demonstrated skills in critical thinking, problem solving, and the analysis, interpretation, and evaluation of complex information
• Demonstrated ability to work independently
• Excellent inter-personal, cross-functional coordination and communication skills
• Strong project management skills
• Strong, verbal, writing, and presentation skills
• Computer skills: Microsoft Word, Excel, PowerPoint, and database software
• Strong communication, time management, and organization skills
• Demonstrated success in managing many projects at one time
• Demonstrated success in supporting internal clients and departments

Mental Requirements:

• Strong verbal and written communication skills, with various levels of the organization and with clients.
• Strong organization skills, accuracy, and high attention to detail.
• Ability to navigate and analyze data from multiple systems.
• Ability to work with a high volume of transactions in a timely manner, and meet deadlines.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Base compensation ranges from $94,500 to $115,500. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.” 

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 10/1/2024

Applications are assessed on a rolling basis. We anticipate that the application window will close on 1/1/2025 but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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