Star Rating Business Analyst

Star Rating Business Analyst Pay Range: $65,600.00 - $98,400.00 We are looking for a Star Rating Business Analyst to conduct advanced analytics, reporting and performance measurement that directly supports Medicare Advantage Star Ratings performance improvement. This role translates complex healthcare and administrative data into actionable insights that inform strategy, prioritize interventions and track progress across clinical quality, member experience and operational measures. Responsibilities Partner with Star Rating program leadership, quality improvement teams, analytics colleagues and vendors to support strategy development and evaluation of interventions. Synthesize large and complex healthcare datasets curated by enterprise data and analytics teams to identify performance drivers, risks and opportunities for improvement across clinical quality, CAHPS/HOS, pharmacy and operational measures. Translate complex Star performance analyses into clear, actionable insights and present findings to diverse audiences—including executives, governance forums and cross‑functional partners. Design, develop and maintain recurring and ad hoc Star Rating reports and performance summaries for leadership and cross‑functional stakeholders. Apply a deep understanding of Star Ratings specifications, methodologies, cut points and CMS guidance to ensure analytical accuracy and business relevance. Develop and document analytical methodologies, assumptions and business rules to ensure transparency, consistency and audit readiness. Perform other duties as assigned. Qualifications Bachelor’s degree in Analytics, Data Science, Computer Science, Mathematics, Economics, Public Health or related field; or an equivalent combination of education and experience. Three to five years of health data analysis, business analysis or performance reporting. Demonstrated experience working with Medicare Advantage Star Ratings data and measures. Direct experience supporting Medicare Advantage Star Rating performance improvement analytics. Strong understanding of CMS Medicare Advantage Star Rating domains, including Clinical Quality (HEDIS), Member Experience (CAHPS/HOS), Pharmacy and Operational measures. Hands‑on experience with Star Rating data sets such as medical and pharmacy claims, enrollment and eligibility, provider data, clinical quality/HEDIS outputs and CAHPS/HOS survey data. Demonstrated ability to apply Star Ratings methodologies, measure specifications, scoring logic and performance timelines (e.g., measurement year vs. payment year) to analytic work. Experience designing executive and governance‑ready Star Ratings reports and dashboards (e.g., Power BI, Tableau) that clearly communicate measure performance, trends and improvement opportunities to technical and non‑technical audiences. Experience leveraging Microsoft Copilot or other AI‑assisted analytics and productivity tools to enhance analysis, reporting efficiency and documentation in a regulated healthcare environment. Excellent verbal and written communication skills; strong problem‑solving, organizational and prioritization abilities; ability to interface with employees at all levels; and ability to handle multiple priorities / projects. Location & Schedule BCBSRI is headquartered in downtown Providence. The position offers flexible work arrangements: onsite 5 days per week, onsite 2–4 days per week, or onsite 0–1 days per week (remote). Applicants may reside in Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas or Virginia, pending approval. Equal Opportunity BCBSRI is an equal opportunity employer and is committed to a workplace that welcomes all. The law requires an employer to post notices describing the Federal laws. #J-18808-Ljbffr Blue Cross & Blue Shield of Rhode Island