Medicare Star Strategy Consultant

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality affordable healthcare. Serving nearly 2 million members Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. Weve had a long-standing commitment to inclusion and equal healthcare access and outcomes regardless of background; its at the core of who we are. We value the rich mix of backgrounds perspectives and experiences of all of our colleagues which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve live and work.

We enjoy the important work we do every day in service to our members partners colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

Point32Health is elevating the way it drives Medicare Star Ratings moving from reporting on performance to strategically shaping it. Reporting to the Director Medicare Star Strategy and partnering closely with Enterprise Clinical Strategy and Stars & Quality leadership the Stars Strategy Consultant is a strategic doer who can turn Star performance data into insight sizes and pressure-tests improvement opportunities and builds the analytics models and materials that move the most promising ideas from insight to action across all Medicare Advantage contracts. This role blends rigorous Stars analytics with a strategy consulting toolkit and is ideal for a high-performing analyst or associate from a top-tier strategy consulting firm who wants to apply structured problem-solving to one of the most important quality and affordability challenges in health care.

Job Description

Key Responsibilities/Duties what you will be doing:

• Stars analytics & reporting: Execute timely and accurate data sourcing validation analytics and reporting across Medicare Advantage contracts including monthly Star performance and member-level data annual survey data and CMS data producing insightful and actionable reports dashboards and member-level views.
• Performance monitoring & root-cause analysis: Monitor and evaluate current and anticipated Part C and Part D measure trends and conduct structured root-cause analysis for measures trending low cutting across geographies markets and provider groups to pinpoint the drivers behind performance gaps.
• Problem framing & opportunity sizing: Break down ambiguous performance questions into structured solvable problems; develop hypotheses and issue trees and build quantitative models to size and pressure-test improvement opportunities clearly stating assumptions sensitivities and confidence behind each estimate.
• Solution development & benchmarking: Research and compare potential interventions benchmark external approaches and assemble the analytic and business case that helps leadership prioritize the highest-value paths to sustainable 4 Star achievement including the rising weight of pharmacy and CAHPS-driven measures.
• Data correlation & insight: Identify and analyze correlations across data sources including Member and Provider Satisfaction data HEDIS CAHPS HOS and operational metrics to enable comprehensive well-supported business decisions.
• Initiative execution support: Help drive prioritized opportunities from concept toward well-formed initiatives that create measurable value in Star ratings and total cost of care tracking milestones dependencies and impact.
• Executive-ready communication: Translate complex analysis into clear compelling storylines slides and briefs and prepare or support written reports and oral presentations of findings to internal and external stakeholders distilling large amounts of information into a few decision-ready insights.
• Tools documentation & governance: Build dashboards and visualizations in platforms such as Power BI or Tableau and develop and maintain policies procedures documentation and folder management for all Star-related data analysis query and report building and presentation establishing repeatable templates that make the capability durable.
• Cross-functional partnership: Provide analytical and consultative support to a broad spectrum of internal business areas and measure owners and participate in teams meetings and workgroups that require Star expertise converting insight into prioritized sized improvement opportunities.

Skills & Competencies

The Consultant will be a fast learner and self-starter with a strong analytical mind-set critical and organized thinking and a collaborative attitude who thrives in ambiguity and manages multiple workstreams at once. Additional skills and competencies include:

• Analytical Rigor: Applies structured problem-solving and quantitative discipline to unstructured incomplete information producing analyses that are accurate well-documented and defensible under scrutiny.
• Acts Strategically: Connects individual analyses to the broader Stars and enterprise clinical strategy and is willing to challenge legacy assumptions and historical performance ceilings treating them as hypotheses to be tested and reset rather than fixed limits.
• Customer Focus: Keeps the ultimate impact on members and customers at the center of the work and builds trust-based relationships with internal stakeholders whose data and input the analysis depends on.
• Accountability: Takes ownership of assigned workstreams delivers reliable on-time output with attention to detail and proactively flags risks gaps and opportunities.
• Other duties and projects as assigned.

Qualifications what you need to perform the job

Preferred Qualifications

• Direct experience with Medicare Stars HEDIS CAHPS/HOS or health plan quality programs and familiarity with CMS Star measure methodology.
• Exposure to health plan operations and value-based / total-cost-of-care models.

Certification and Licensure

Education

• Bachelors degree required; advanced coursework or a graduate degree (MBA MHA MPH or related) is a plus.

Experience

• 4 years of experience at the analyst or associate level with a top-tier strategy consulting firm or comparable corporate strategy health plan or healthcare analytics experience.

Skill Requirements

• Demonstrated ability to structure ambiguous problems build quantitative models and translate analysis into clear recommendations.
• Strong proficiency in Excel/financial modeling and PowerPoint with hands-on experience in data visualization platforms such as Power BI or Tableau.
• Excellent written and verbal communication with the ability to distill complex analysis into executive-ready materials.
• Comfort working with large complex data sets and drawing sound well-caveated conclusions from them.

Working Conditions and Additional Requirements (include special requirements e.g. lifting travel):

• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.
• Anything specific to physical needs (lifting etc.)

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Salary Range

$102377.60 -$153566.40

Compensation & Total Rewards Overview

The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors including the scope and complexity of the role; the skills education training credentials and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program colleagues are also eligible for variable pay. Eligibility for any bonus commission benefits or any other form of compensation andbenefits remains in the Companys sole discretion and maybe modified at the Companys sole discretion consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical dental and vision coverage

• Retirement plans

• Paid time off

• Employer-paid life and disability insurance with additional buy-up coverage options

• Tuition program

• Well-being benefits

• Full suite of benefits to support career development individual & family health and financial health

For more details on our total rewards programs visit welcome all
All applicants are welcome and will receive consideration for employment without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age or veteran status.

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