Sr Analyst, Medical Economics, Stars and Risk Adjustment
Position: Senior Analyst of Medical Economics, Stars and Risk Adjustment
The Senior Analyst of Medical Economics, Stars and Risk Adjustment, will play a key role in advancing Monogram Health’s analytical capabilities and driving performance in Star Ratings and Risk Adjustment documentation accuracy. This role will collaborate with key business leaders to create standardized reporting, generate actionable insights and drive strategic initiatives that support performance improvement.
The Senior Analyst partners with internal stakeholders to deliver standardized reporting, identify performance gaps, and support operational improvement initiatives.
Responsibilities
• Develop and maintain standardized Stars and Risk Adjustment reporting using internal data sources and CMS files within Databricks and Power BI
• Lead code development and end-user dashboard creation, applying subject-matter expertise to meet defined business needs
• Serve as a subject matter expert on Risk Adjustment data sources, including MAO-004, 837, MMR, and MOR files
• Present internal overviews and detailed analytical findings to stakeholders to ensure alignment and clarity on next steps
• Analyze data to identify trends, performance opportunities and develop actions plans to address gaps
• Build a deep understanding of clinical workflows and collaborate to enhance processes that support departmental efficiency and effectiveness
• Partner with internal teams to share insights that may influence underwriting, contracting, operations and other business areas
• Support the growth of direct and matrixed team members by fostering knowledge‑sharing and sustainable progress toward departmental goals
Position Requirements
• Bachelor’s degree required; Master’s degree in healthcare or a related field, or actuarial certification (FSA/ASA in progress of completed) preferred
• Minimum of two (2) years of experience in Medicare Advantage Stars or Risk Adjustment analytics
• Proficiency in SQL, R, and Python; experience working with large enterprise data warehouses; strong ability to build, modify and optimize data tables; intermediate-to-advanced Power BI skills, including complex DAX and data modeling
• Knowledge of CMS Risk Adjustment and Stars data sources (MAO-004, 837, MMR, MOR)
• Ability to translate data into clear, actionable insights
• Communication skills and ability to collaborate in a matrixed environment and influence others to drive outcomes
Benefits
• Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
• Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
• Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
• Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
About Monogram Health
Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
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The Senior Analyst of Medical Economics, Stars and Risk Adjustment, will play a key role in advancing Monogram Health’s analytical capabilities and driving performance in Star Ratings and Risk Adjustment documentation accuracy. This role will collaborate with key business leaders to create standardized reporting, generate actionable insights and drive strategic initiatives that support performance improvement.
The Senior Analyst partners with internal stakeholders to deliver standardized reporting, identify performance gaps, and support operational improvement initiatives.
Responsibilities
• Develop and maintain standardized Stars and Risk Adjustment reporting using internal data sources and CMS files within Databricks and Power BI
• Lead code development and end-user dashboard creation, applying subject-matter expertise to meet defined business needs
• Serve as a subject matter expert on Risk Adjustment data sources, including MAO-004, 837, MMR, and MOR files
• Present internal overviews and detailed analytical findings to stakeholders to ensure alignment and clarity on next steps
• Analyze data to identify trends, performance opportunities and develop actions plans to address gaps
• Build a deep understanding of clinical workflows and collaborate to enhance processes that support departmental efficiency and effectiveness
• Partner with internal teams to share insights that may influence underwriting, contracting, operations and other business areas
• Support the growth of direct and matrixed team members by fostering knowledge‑sharing and sustainable progress toward departmental goals
Position Requirements
• Bachelor’s degree required; Master’s degree in healthcare or a related field, or actuarial certification (FSA/ASA in progress of completed) preferred
• Minimum of two (2) years of experience in Medicare Advantage Stars or Risk Adjustment analytics
• Proficiency in SQL, R, and Python; experience working with large enterprise data warehouses; strong ability to build, modify and optimize data tables; intermediate-to-advanced Power BI skills, including complex DAX and data modeling
• Knowledge of CMS Risk Adjustment and Stars data sources (MAO-004, 837, MMR, MOR)
• Ability to translate data into clear, actionable insights
• Communication skills and ability to collaborate in a matrixed environment and influence others to drive outcomes
Benefits
• Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
• Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
• Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
• Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
About Monogram Health
Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
#LI-AS1
Apply tot his job
Apply To this Job