Data Analyst

Project Details:

Star Rating Reporting Project – Summary

STAR RATINGS - Managed and scored by the Centers for Medicare and Medicaid

Services (CMS) 

The Star Rating Reporting Project focuses on delivering accurate and timely

healthcare quality and operational reporting to support business stakeholders,

leadership teams, and compliance initiatives. The project involves data extraction,

transformation, validation, and reporting of key healthcare performance measures to

track member outcomes, provider performance, and organizational goals.

Job Description:

Key Responsibilities

Gather, analyze, and validate data from multiple healthcare data sources.

Maintain reporting processes for quality and operational measures.

Performed data validation and quality checks to identify and resolve

discrepancies.

Ensure data accuracy through validation, reconciliation, and quality checks.

Automated and streamlined reporting processes to reduce manual effort and

improve efficiency.

Collaborate with business users, analysts, and leadership teams to understand

reporting requirements and deliver actionable insights.

Support report enhancements, troubleshooting, and ongoing maintenance

activities.

Reporting Areas Supported

Poly-ACH Reporting

Work on reporting related to Polypharmacy in Older Adults (Poly-

ACH) measures.

Extract and analyze member medication data to identify compliance and

adherence trends.

Validate measure calculations and ensured regulatory reporting standards were

met.

Provide insights to support quality improvement initiatives.

COB (Coordination of Benefits) Reporting

Support COB reporting processes by analyzing member eligibility and coverage

information.

Identify discrepancies across systems and assisted in data reconciliation efforts.

Generate reports that improved visibility into benefit coordination activities and

operational performance.

Medication Adherence Reporting

Develop and maintain reports for medication adherence measures.

Monitor adherence trends related to chronic conditions such as diabetes,

hypertension, and cholesterol management.

Perform data validation to ensure reporting accuracy and compliance with

healthcare quality requirements.

Deliver insights to stakeholders to support member outreach and quality

improvement programs.

SUPD Reporting

Support Statin Use in Persons with Diabetes (SUPD) reporting initiatives.

Analyze member and prescription data to measure compliance and identify care

gaps.

Maintain reporting logic and performed quality checks to ensure reliable results.

Assist stakeholders in tracking performance metrics and identifying improvement

opportunities.

Technical Skills:

SQL Server & Database Management

Strong knowledge of Microsoft SQL Server environments.

Experience working with large datasets and healthcare-related databases.

Perform data extraction, transformation, and validation activities.

SQL Query Development

Develop complex SQL queries for reporting and analytics.

Create stored procedures, views, joins, and data validation scripts.

Optimize query performance for large-volume reporting processes.

Conduct root cause analysis and data investigations using SQL.

Azure DevOps

Azure DevOps for work item tracking, sprint management, and release

coordination.

Manage user stories, tasks, defects, and change requests.

Participate in Agile development processes and collaborated with cross-

functional teams.

Support deployment and testing activities through Azure DevOps workflows.

Reporting & Data Analysis

Data analysis and reporting development.

Report automation and process improvement.

Data quality management and reconciliation.

Business requirements gathering and stakeholder collaboration.

Operational and healthcare quality reporting.

Tools & Technologies

Healthcare Domain Knowledge

o STAR Rating/Measures

Medication Adherence

SUPD

Poly-ACH

COB

o HEDIS Measures

Microsoft SQL Server

o SQL Query Writing

o Stored Procedures

o Views

o Joins

o Data Validation

Azure DevOps

o Sprint Planning, User Story Management, Defect Tracking, Release

Tracking, Agile Methodology

Microsoft Excel

o Pivot Tables, VLOOKUP/XLOOKUP, Data Analysis, Reporting

Power BI (if applicable)

o Dashboard Development

o Data Visualization

o KPI Monitoring

Microsoft Office Suite

o Excel, Word, PowerPoint

Microsoft Power BI