Remote Nationwide, United States of America
Remote only
Location: remote
The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.
In this pivotal role, you will provide analytical expertise and strategic insights that drive our Stars program success. Your work will directly support leadership decision-making and the advancement of Stars improvement efforts. This is an exciting opportunity for a seasoned professional to influence outcomes that improve member health, enhance plan quality and drive organizational growth.
Key Responsibilities:
Strategic Analysis:
Analyze the impact of member growth, retention and movement on Star Ratings working with claims, clinical and quality data.
Develop insights that inform business strategies and operational improvements to support Star Rating goals
Interpret complex data to evaluate program nuances and their implications on performance
Leadership Support:
Prepare high-quality, data-driven materials for VP and senior leadership discussions
Participate in strategic conversations, providing actionable insights and recommendations
Communicate complex analytical findings in a clear and compelling manner to non-technical audiences
Stars Improvement Initiatives:
Collaborate with cross-functional teams to assess and enhance Stars performance
Act as a subject matter expert, explaining the intricacies of Stars methodology and metrics
Data Visualization and Reporting:
Create executive-level dashboards and presentations that showcase key metrics, trends and improvement opportunities
Ensure data accuracy, consistency and clarity in all reporting and analysis
Role Essentials
Bachelor's degree
7 or more years of technical experience in data analysis
3+ years of experience in Medicare Advantage, Stars programs or healthcare analytics
Strong understanding of CMS Star Ratings and Medicare Advantage programs
Experience with tools such as Tableau, SQL, Power BI and/or QlikView
Advanced experience working with big and complex data sets within large organizations
Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
Excellent communication and presentation skills, with the ability to convey complex concepts clearly to senior leadership
Role Desirables
Experience with payer claims data
Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field
Advanced in SQL, SAS and other data systems
Experience with tools such as Tableau and Qlik for creating data visualizations
Expertise in data mining, forecasting, simulation, and/or predictive modeling
Experience creating analytics solutions for various healthcare sectors
Additional Information
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 06-15-2026
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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