Member Experience Data Analyst

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Conducts data analysis, reporting, and interpretation of Member Experience operational reporting, including but not limited to CAHPS survey results, member complaints and grievances, call frequency metrics, disenrollment trends, and member satisfaction indicators.
• Serves as the primary analytical owner for CMS Star Ratings Member Experience measures, including monitoring performance across CAHPS domains such as Getting Needed Care, Customer Service, Rating of Health Plan, and Care Coordination.
• Monitors performance against Star Ratings benchmarks and internal targets, identifying trends, performance gaps, and improvement opportunities.
• Analyzes customer and member satisfaction metrics, including CAHPS, Net Promoter Score (NPS), retention indicators, and other experience measures, to evaluate member sentiment and service performance.
• Analyzes CAHPS and interim survey results and related domains to identify trends, drivers of member satisfaction, and opportunities for improvement.
• Partners with operational teams to translate survey insights into actionable improvement initiatives.
• Conducts deep-dive analysis of survey responses, member feedback, and operational data to identify root causes of member experience challenges.
• Monitors member contact patterns, including call center engagement, repeat calls, and call frequency metrics to identify operational opportunities to improve member experience and reduce unnecessary utilization.
• Analyzes patterns in member inquiries and service interactions to identify systemic operational issues impacting member satisfaction.
• Analyzes member disenrollment patterns, including voluntary and involuntary disenrollment trends, to identify drivers of member attrition.
• Supports development of predictive modeling approaches to identify members at risk for disenrollment and/or at risk for low satisfaction, enabling targeted retention and outreach strategies.
• Conducts member journey analysis by integrating data across multiple touchpoints including enrollment, customer service interactions, care management engagement, complaints, and surveys.
• Analyzes member engagement across operational touchpoints including care management interactions, call center contacts, grievances, and service utilization to identify drivers of member satisfaction and opportunities to improve member experience across the lifecycle of plan enrollment and engagement.
• Leads the design and development of Member Experience analytics dashboards and KPIs, enabling leadership and operational teams to monitor performance trends related to CAHPS, member engagement, call frequency, complaints, and disenrollment.
• Independently develops key performance indicators (KPIs), reporting frameworks, and dashboard solutions from concept through implementation.
• Develops and maintains automated reporting solutions and data visualizations using business intelligence tools such as MicroStrategy or Tableau.
• Identifies opportunities to improve reporting efficiency through automation, dashboard redesign, and improved data integration.
• Retrieves, compiles, and validates data from multiple internal and external sources including survey vendors, call center systems, operational databases, and claims data.
• Writes and maintains advanced SQL queries to extract, transform, and analyze large datasets.
• Utilizes cloud-based data platforms such as Snowflake to support data extraction, analysis, and reporting.
• Identifies and resolves data integrity issues and develops validation processes to ensure accuracy and reliability of reporting.
• Develops data quality specifications and validation processes for member experience reporting systems.
• Collaborates with Member Experience, Quality Management, Clinical Operations, Membership Operations, Information Technology (IT), and Business Intelligence & Analytics (BIA) teams to support performance monitoring and improvement initiatives.
• Prepares analytical summaries, reports, and presentations communicating key insights and recommendations to leadership and non-technical stakeholders.
• Serves as a strategic thought partner to Member Experience and Quality leadership, providing data-driven recommendations to inform operational and clinical improvement strategies
• Provides secondary analytical support for Quality/HEDIS reporting and quality improvement initiatives as needed.
• Participates in special projects and performs other duties as assigned.

Education:

• Bachelor's Degree in Statistics, Biostatistics, Mathematics, Public Health, Epidemiology, Health Informatics, Healthcare Administration, Data Analytics, or related field with equivalent knowledge required
• Master's Degree in Statistics, Biostatistics, Mathematics, Public Health, Epidemiology, Health Informatics, Healthcare Administration, Data Analytics, or related field with equivalent knowledge preferred

Work Experience:

• Minimum of two years' experience performing data analysis and interpretation, preferably in a managed care or health care setting required
• Experience with data extraction and manipulation required
• Advanced SQL proficiency required
• Experience developing KPIs, dashboards, and reporting solutions independently required
• Experience with data visualization tools (MicroStrategy, Tableau, Power BI, or similar) required
• Advanced Microsoft Office skills (Excel, PowerPoint, Word) required
• Effective oral, written, and interpersonal communication skills required
• Ability to manage multiple priorities in a fast-paced environment required
• Experience performing customer or member satisfaction analytics (e.g., CAHPS, NPS, retention, customer experience metrics) preferred
• Experience working with Medicare Advantage, Managed Long-Term Care (MLTC), Medicaid, or other government-sponsored health plan programs preferred
• Healthcare industry domain knowledge preferred
• Experience with claims data and health plan quality metrics (e.g., HEDIS, QARR, CMS Star Ratings) preferred
• Experience with Snowflake or similar cloud data platforms preferred
• Experience conducting statistical analysis or predictive modeling using tools such as R, Python, or SAS preferred