Project Details

Star Rating Reporting Project – Summary

STAR RATINGS - Managed and scored by the Centers for Medicare and Medicaid

Services (CMS)

The Star Rating Reporting Project focuses on delivering accurate and timely healthcare quality and operational reporting to support business stakeholders,

leadership teams, and compliance initiatives. The project involves data extraction,

transformation, validation, and reporting of key healthcare performance measures to track member outcomes, provider performance, and organizational goals.

Key Responsibilities

 Gather, analyze, and validate data from multiple healthcare data sources.

 Maintain reporting processes for quality and operational measures.

 Performed data validation and quality checks to identify and resolve discrepancies.

 Ensure data accuracy through validation, reconciliation, and quality checks.

 Automated and streamlined reporting processes to reduce manual effort and improve efficiency.

 Collaborate with business users, analysts, and leadership teams to understand reporting requirements and deliver actionable insights.

 Support report enhancements, troubleshooting, and ongoing maintenance activities.

Reporting Areas Supported

Poly-ACH Reporting

 Work on reporting related to Polypharmacy in Older Adults (Poly-

ACH) measures.

 Extract and analyze member medication data to identify compliance and adherence trends.

 Validate measure calculations and ensured regulatory reporting standards were met.

 Provide insights to support quality improvement initiatives.

COB (Coordination of Perks) Reporting





 Support COB reporting processes by analyzing member eligibility and coverage information.

 Identify discrepancies across systems and assisted in data reconciliation efforts.

 Generate reports that improved visibility into benefit coordination activities and operational performance.

Medication Adherence Reporting

 Develop and maintain reports for medication adherence measures.

 Monitor adherence trends related to chronic conditions such as diabetes,

hypertension, and cholesterol management.

 Perform data validation to ensure reporting accuracy and compliance with healthcare quality requirements.

 Deliver insights to stakeholders to support member outreach and quality improvement programs.

SUPD Reporting

 Support Statin Use in Persons with Diabetes (SUPD) reporting initiatives.

 Analyze member and prescription data to measure compliance and identify care gaps.

 Maintain reporting logic and performed quality checks to ensure reliable results.

 Assist stakeholders in tracking performance metrics and identifying improvement opportunities.

Technical Skills

SQL Server & Database Management

 Strong knowledge of Microsoft SQL Server environments.

 Experience working with large datasets and healthcare-related databases.

 Perform data extraction, transformation,



and validation activities.

SQL Query Development

 Develop complex SQL queries for reporting and analytics.

 Create stored procedures, views, joins, and data validation scripts.

 Optimize query performance for large-volume reporting processes.

 Conduct root cause analysis and data investigations using SQL.

Azure DevOps

 Azure DevOps for work item tracking, sprint management, and release coordination.

 Manage user stories, tasks, defects, and change requests.

 Participate in Agile development processes and collaborated with cross-

functional teams.

 Support deployment and testing activities through Azure DevOps workflows.

Reporting & Data Analysis

 Data analysis and reporting development.

 Report automation and process improvement.

 Data quality management and reconciliation.

 Business requirements gathering and stakeholder collaboration.

 Operational and healthcare quality reporting.

Tools & Technologies

 Healthcare Domain Knowledge o STAR Rating/Measures

 Medication Adherence

 SUPD

 Poly-ACH

 COB o HEDIS Measures

 Microsoft SQL Server o SQL Query Writing o Stored Procedures o Views o Joins o Data Validation

 Azure DevOps o Sprint Planning, User Story Management, Defect Tracking, Release

Tracking, Agile Methodology

 Microsoft Excel o Pivot Tables, VLOOKUP/XLOOKUP, Data Analysis, Reporting

 Power BI (if applicable)

o Dashboard Development o Data Visualization o KPI Monitoring

 Microsoft Office Suite o Excel, Word, PowerPoint

 Microsoft Power BI

📌 Data analyst _HC (India)
🏢 Cognizant
📍 India