Demo

Pharmacy STARS and HEDIS Data Analyst (Remote) Non-Technical

CareFirst BlueCross BlueShield
Baltimore, MD Remote Full Time
POSTED ON 4/15/2025
AVAILABLE BEFORE 5/14/2025
Resp & Qualifications

Although this position is remote, candidates are preferred to live in the MD, DC, VA area in order to travel into the local offices.

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 in Data Science, Mathematics, Computer Science, Statistics, Business or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 3 years of post-college work 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 & Pharmacy Data experience

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.
  • 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.

Salary Range: $72,000 - $143,000 (salaries are based on education, years of experience & internal equity).

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Government Programs Specialty

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.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

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.

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

Salary : $72,000 - $143,000

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