Alterwood Health Management Company, Inc. · 11 hours ago
Health Data Analyst II
United States
Full-time
Onsite
Mid, Senior Level
$82K/yr - $95K/yr
3+ years expAlterwood Health is a fast-growing Medicare Advantage health maintenance organization seeking a strong and dynamic Health Data Analyst II. This role supports quality improvement and regulatory compliance initiatives across Medicare Advantage programs through data collection and complex analytics to improve outcomes in Star Ratings and HEDIS measures.
HealthcareProfessional ServicesHealth CareService Industry
Responsibilities
Lead Medicare Advantage Star Ratings initiatives by performing data analysis, performance monitoring, and gap-to-goal reporting across Part C and Part D measures (e.g., medication adherence, preventive screenings, chronic condition management, member experience surveys)
Manage with Risk Adjustment programs by supporting medical record retrieval tracking, data validation, and preparation of reports for retrospective and prospective reviews and CMS RADV audit readiness
Extract and analyze complex data from EHR, claims, encounter, and pharmacy systems to assess performance on quality, Stars, and risk adjustment metrics; identify trends, root causes and opportunities for improvement
Create dashboards, reports, and presentations that translate data findings into clear, actionable insights for stakeholders
Coordinate and track HEDIS roadmap submissions, ensuring timely completion and accuracy of required reporting
Maintain expert-level working knowledge of CMS, NCQA, and Stars memos and regulatory updates; maintain organized documentation of changes
Track CMS guidance documents and regulatory changes; summarize and communicate relevant updates to team members and stakeholders
Draft relevant comments based on CMS proposed rules and policy changes as directed
Support organizational compliance efforts by generating required reports
Research, compile, and distribute regulatory, operational, and ad-hoc reports based on project and leadership priorities
Serve as a subject matter expert and primary liaison for EHR-based quality and risk adjustment initiatives
Collaborate with provider relations team and IT team to support EHR data extraction, validation, mapping, and submission for quality and risk adjustment programs
Drive implementation and optimization of EHR workflows for structured data capture, and quality measure reporting
Identify and document data quality issues related to EHR feeds, clinical documentation, and interoperability that impact Stars, HEDIS, and Risk Adjustment performance; escalate issues as appropriate
Qualification
Required
Bachelor's degree in Health Information Management, Public Health, Data Analytics, Healthcare Administration, or related field with at least 5-7 years of experience or Master's degree in analytical discipline with at least Three (3) year of health analytics experience related to Medicare, Stars or HEDIS preferred
Proven experience to CMS Stars, HEDIS measures, or Risk Adjustment concepts through prior work experience
Strong understanding of CMS regulatory frameworks and compliance requirements
Advanced analytical and problem-solving skills, including predictive modeling, with exceptional attention to detail
Proficiency in Microsoft Excel
Intermediate and advanced knowledge of SQL
Understanding of healthcare quality metrics and performance measurement
Excellent written and verbal communication skills
Ability to work collaboratively in a team environment and manage multiple tasks
Strong knowledge of healthcare claims and encounter data
Experience with data quality assessment or validation
Strong knowledge of data visualization tools (Power BI, Tableau, or similar)
Preferred
Knowledge of EHR systems (Epic, Cerner, or similar)
Experience with Risk adjustment models
Benefits
401(k)
401(k) matching
Dental insurance
Disability insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance
Company
Alterwood Health Management Company, Inc.
Alterwood Health is a newly formed managed care organization.
51-200 employees
H1B Sponsorship
Alterwood Health Management Company, Inc. has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (1)
2024 (2)
2022 (3)
Funding
Current Stage
Growth StageTotal Funding
$10.45M2021-05-06Series Unknown· $10.45M
2021-03-01Seed
Leadership Team
Daniel Myers
Chief Information Officer / Co-Founder
James Davis
Co-Founder and Chief Marketing Officer
Recent News
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