Senior Medicare Advantage Stars Analyst – CMS Quality & Performance

Fallon Health

. Serve as the primary analytical resource supporting Fallon Health's Medicare Star Ratings strategy .

Posted 11/4/2026full-timeWorcester • Massachusetts • United StatesSenior💰 $125,000 - $130,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Medicare Star Ratings methodology, performance measurement, and data analytics, with a strong ability to analyze complex healthcare datasets and translate findings into actionable business recommendations. Proficient in developing KPIs, dashboards, and reports to monitor performance and support strategic planning initiatives.

Highest-signal resume keywords

Medicare Star Ratings MethodologyAdvanced Analytical SkillsSQL and Data Extraction ToolsKPI Development and BenchmarkingMicrosoft Excel Proficiency

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Data AnalysisPerformance MeasurementForecastingDashboard DevelopmentRoot-Cause AnalysisStatistical AnalysisData VisualizationQuality ImprovementTrend AnalysisReporting

Soft Skills

Problem-SolvingCommunication SkillsCollaboration SkillsFacilitation SkillsCritical Thinking

Tools & Technologies

Microsoft Office SuiteData Visualization ToolsAnalytical ToolsReporting Solutions

Industry Keywords

Healthcare AdministrationHEDISCAHPSHOSCMS Quality ProgramsHealthcare OperationsClaims DataEnrollment DataQuality DataSocial Determinants of Health

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Serve as the primary analytical resource supporting Fallon Health's Medicare Star Ratings strategy
Monitor and evaluate performance across all CMS Star measures
Develop and maintain internal dashboards, exhibits, and surveillance reports
Identify emerging performance risks, opportunities, and trends affecting Star Ratings outcomes
Track measure-level interventions and assess effectiveness of improvement activities
Partner with business owners and department leaders to establish accountability and performance monitoring processes
Support annual Stars planning, goal setting, and performance reviews
Identify cultural trends, demographic patterns, disparities, and social determinants of health affecting Medicare Star performance
Analyze provider practice patterns to identify performance variation, barriers, and improvement opportunities
Identify and define KPIs, establish accountability tracking, and lead routine performance reviews
Manage and participate in meetings across Medicare 5-Star domains, including agenda development, performance review, action tracking, and follow-up
Serve as primary liaison between Fallon Health and Hyperlift for Medicare Stars analytics and reporting
Collaborate with Hyperlift to develop, validate, and interpret Star Ratings projections and forecast models
Monitor monthly and annual performance forecasts and recommend intervention strategies
Validate vendor reporting outputs and reconcile forecasts with internal reporting and operational data
Design, develop, maintain, and enhance operational and regulatory reports
Analyze large healthcare datasets to identify trends, patterns, and root causes
Create ad hoc analyses and executive presentations
Validate data integrity and reconcile reporting outputs across multiple systems
Develop measures, KPIs, and analytical frameworks to evaluate business performance
Support predictive and trend analysis
Define requirements with technical resources for accurate reporting and analytical outputs
Develop alternative methods to obtain or approximate unavailable data, with validation and documentation
Translate analytical findings into actionable business recommendations
Participate in root cause investigations and corrective action planning
Support process improvement initiatives related to Star measures and quality performance
Provide analytical consultation for cross-functional projects impacting Medicare quality outcomes
Identify reporting efficiencies and automation opportunities
Conduct end-to-end reviews of processes supporting Medicare Star measures
Participate in enterprise projects supporting Medicare, quality, compliance, and operational objectives
Assist leadership with strategic planning and performance improvement initiatives
Support implementation and testing of new reporting solutions and analytical tools
Perform additional duties as assigned

Requirements

What you’ll need

Applicants must be authorized to work in the United States
Bachelor's Degree in Healthcare Administration, Health Informatics, Data Analytics, Business, Public Health, Statistics, or related field
Knowledge of Medicare Star Ratings methodology and performance measurement
Understanding of HEDIS, CAHPS, HOS, and CMS quality programs
Knowledge of healthcare operations, claims, enrollment, provider, and quality data
Understanding of performance measurement, KPI development, and benchmarking methodologies
Advanced analytical and critical thinking skills
Ability to identify patterns, trends, risks, and opportunities within complex datasets
Strong problem-solving and root-cause analysis capabilities
Ability to develop forecasts and performance projections
Advanced Microsoft Excel skills
Experience with SQL and data extraction tools
Experience developing dashboards and visualization tools
Proficiency with Microsoft Office Suite
Ability to communicate complex technical information to non-technical audiences
Strong written and verbal communication skills
Ability to present findings to leadership and business stakeholders
Strong facilitation and collaboration skills
Demonstrated ability to independently identify, assess, and resolve complex problems; proactive self-starter with sound judgment and appropriate escalation practices