Remote Medicare Analyst Jobs (NOW HIRING)

Primary City/State:

Phoenix, Arizona

Department Name:

Medicare Stars Strategy

Work Shift:

Day

Job Category:

General Operations

Help move health care into the future. At Banner Plans & Networks we are changing health care to make the experience the best it can be. If that sounds like something you want to be part of, apply today.

Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities.

The Director of Medicare STARS Analytics & Reporting serves as a strategic leader responsible for ensuring the complete, accurate, and timely submission of Medicare Part C and Part D data. Each day involves overseeing the development, maintenance, and governance of reporting and analytical tools that provide clear visibility into Stars performance and support operational and strategic decision making across the organization.

In this role, you will guide a high performing analytics team, fostering technical excellence and professional growth while advancing the organization's predictive modeling and analytic capabilities. As a key leader within the STARS organization, you will collaborate closely with cross functional partners, translating complex data into actionable insights that drive sustained Stars performance and quality outcomes.

Key Responsibilities & Experience

• Lead and mentor a team of 2 data analysts, overseeing the development of standardized and ad hoc reporting to drive insights and support strategic decision-making.
• Train and support staff in the use of Power BI and other industry-standard tools for data modeling and visualization.
• Leverage deep expertise in the Medicare Star Ratings program, including technical specifications, cut points, and performance metrics, to guide analytics and improvement initiatives.
• Develop, maintain, and enhance predictive modeling tools that incorporate current performance data, predictive analytics packages, and Star Ratings methodologies.
• Serve as a strategic advisor on the BMA Stars team, contributing to performance improvement activities and cross-functional collaboration with IT, analytics, and clinical teams.

Position Details

• Job Type: Full-time, Salaried (Exempt from Overtime)
• Work Arrangement: Hybrid Remote - Must reside and work within the State of Arizona
• Schedule: Primarily Monday through Friday during standard business hours
• Flexibility Required: Occasional early mornings, evenings, and weekends, especially during the Annual Enrollment Period (AEP)

If this role sounds like the one for you, Apply today!

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits. In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards package.Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY

This position provides leadership in the development, deployment, and optimization of advanced analytics that support Banner Health Plan performance within the assigned scope of influence. This position is responsible to lead a team of data scientists and analysts to build analytical tools, data models, and advanced predictive and prescriptive products that improve provider performance, care management and care coordination, and health plan operations. This person will work within a large, complex ecosystem of data sets, IT systems, and data visualization platforms to deliver products to a variety of audiences. Leading through a combination of direct reports and by influence, this role contributes to Banner Health Plan's strategic planning efforts. This person is well-versed in data science landscape, and shares opportunities and insights regarding how Banner Health Plan can best leverage analytical and reporting tools to optimize performance.

CORE FUNCTIONS

1. Leads development of innovative, scalable analytical models (e.g. data mining solutions, data visualization tools) that mine complex healthcare data and transform them into actionable insights. Promotes and facilitates integration of models into business processes as necessary to improve performance.

2. Collaborates with business partners to identify, design, and deploy new analytical tools that leverage predictive and prescriptive insights to improve health plan performance.

3. Monitors utility of existing analytical models and tools, solicits feedback from stakeholders and end-users, and drives quality improvement of the models to continually improve tools.

4. Collaborates very closely with other analytical teams, senior leaders and IT. Acts as an internal consultant, working across teams and departments to deliver short-term and long-term deliverables.

5. Develops code, and leads/oversees the development of code, debugging, optimizing, and production of code sets. Conducts ad hoc analyses, builds predictive models of patient behavior and forecasting models. Defines business requirements for predictive models and analytics tools, ensuring data integrity and end-user acceptance. Ensures continual usability through monitoring, revisions, and trouble-shooting as needed.

6. Monitors market trends, Medicare regulatory and sub-regulatory landscape, and data science industry to share opportunities, challenges, and other market insights to business leaders.

7. Build and grow analytics team to support health plan performance. Establish performance standards, develop plans, provide coaching and mentorship to direct reports and others, as appropriate.
MINIMUM QUALIFICATIONS

Must have a strong knowledge of business and/or healthcare as normally obtained through the completion of a Master's Degree in Statistics, Computer Sciences, Health Sciences Research, Process Engineering, Clinical Informatics, Business or related field.

Requires a minimum of seven years of hands on experience with predictive modeling and statistical analysis techniques in a healthcare environment. An equivalent combination of education and experience may be allowed.

Must have experience in working with cross functional departments in order to serve as a liaison and provide relevant guidance or leadership. Must demonstrate ability to lead complex projects and cross-functional teams, including strong project management skills, to resolve, implement or reach consensus on issues. Excellent communication, interpersonal and critical thinking skills are required.

PREFERRED QUALIFICATIONS

Knowledge of technologies such as Population Health Management (PHM), Clinical Practice Tools, Readmissions, Preventive Medicine, Pharmacy in/out-patient monitory and alerting also preferred. Masters or PhD in Health Services Research, Statistics or related field. Population health research experience.

Additional related education and/or experience preferred.

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