Lead Business Analyst (Member Experience)

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

• Leads annual CMS STAR rating disenrollment compliant audits, providing examples of any gaps that could change our Medicare STAR rating by H-contract. Able to interpret and understand changes to voluntary disenrollment logics according to CMS requirements.
• Leads in the support of business initiatives through CMS STAR rating trend analysis via TRR, identification of membership reasons for disenrollment and recommend opportunities for process improvement in retention planning. Present findings in PowerPoint format for leadership.
• Provides advanced insight and dashboard development support for business leaderships in the following areas: CMS disenrollment (TRR, crosswalk, competitor directories), membership, sales channel, product type/space, regional/state level, H-contract/PBP level datasets with advance Excel, Tableau, and Power-BI tools.
• Provides development of annual STAR voluntary disenrollment rating forecast down to each PBP level to provide guidelines/resources needed to blend the curve and achieve higher STAR ranking for higher CMS bonus.
• Oversees training and mentoring other business and data analysts both internal and external to the team. Serve as the subject matter expert in all things related to CMS STAR rating disenrollment analysis.

Education/Experience: Bachelor’s degree in related field or equivalent experience. 8+ years of statistical analysis or data analysis experience. Healthcare experience preferred. Experience performing CMS Plan Finder “member choosing to leave plan” Star measure audit. Oversee training and mentoring other Business Analysts. Experience managing projects or heavy involvement in project implementation. Advance MS Excel and MS PowerPoint. Ability to understand SQL and SAS queries. Ability to modify Tableau/Power BI dashboards. Travel: Up to 5% nationwide and will require overnight stay.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Originally posted on Himalayas