Senior Analyst, Medical Economics – Stars and Risk Adjustment

🕒 May 12

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Monogram Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2019

⚕️ Healthcare Insurance

🤝 B2B

👥 B2C

Healthcare Insurance • B2B • B2C

Monogram Health is a leading multispecialty provider that delivers in-home, evidence-based care and benefit management for patients with complex, multiple chronic conditions, with a strong focus on chronic kidney disease and related metabolic, cardiovascular, pulmonary, and behavioral health needs. The company coordinates multispecialty clinical teams (nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care), provides 24/7 home-based support including home dialysis and medication management, and partners with payers and physician groups to improve outcomes, reduce hospitalizations, and lower costs.

📋 Description

• 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

🎯 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