Data Analyst (Clinical CMS & NCQA Experience Required)

Atem Corp; Remote; USD 85,000 - 110,000; Full time

Job summary

A healthcare analytics company is seeking an experienced Data Analyst with a strong clinical background and direct project experience in CMS and NCQA quality measures. This role involves supporting healthcare quality reporting, analytics, and regulatory initiatives, with responsibilities in data analysis and warehousing. The ideal candidate will have over 12 years in business analysis and 5+ years specifically in data analysis in clinical environments. Remote work is an option, making this position flexible and suitable for experienced analysts.

Qualifications

• 12+ years of overall Business Analysis experience.
• 5+ years of Data Analysis experience with CMS & NCQA Quality Measures.
• 5+ years of data warehousing experience in a clinical environment.
• Direct hands-on experience with CMS & NCQA projects.

Responsibilities

• Perform advanced data analysis supporting CMS and NCQA quality reporting initiatives.
• Analyze and validate clinical and claims data sourced from EMR/EHR systems.
• Partner with clinical, business, and technical stakeholders to translate regulatory requirements into data solutions.
• Support data warehousing initiatives in a clinical healthcare environment.
• Develop and execute SQL queries to validate measures, metrics, and reporting accuracy.

Skills

SQL

Data Analysis

Business Analysis

SDLC & Agile methodologies

Clinical data experience

Job description

Role Overview

Note- Clinical Experience Mandatory

We are seeking an experienced Data Analyst with a strong clinical background and hands-on CMS & NCQA Quality Measures experience. This role supports healthcare quality reporting, analytics, and regulatory initiatives and requires deep experience working with clinical data in enterprise data warehouse environments.

Mandatory Requirement: Candidates must have direct project experience with CMS and NCQA quality measures. Profiles without this experience will not be considered.

Key Responsibilities

• Perform advanced data analysis supporting CMS and NCQA quality reporting initiatives
• Analyze and validate clinical and claims data sourced from EMR/EHR systems
• Partner with clinical, business, and technical stakeholders to translate regulatory requirements into data solutions
• Support data warehousing initiatives in a clinical healthcare environment
• Develop and execute SQL queries to validate measures, metrics, and reporting accuracy
• Perform data mapping, lineage analysis, and source-to-target documentation
• Participate in full SDLC and Agile delivery cycles
• Ensure compliance with CMS, NCQA, and healthcare quality reporting standards
• Support testing, validation, and reconciliation of quality measures and dashboards
• Document business and technical requirements related to quality measures and reporting

Mandatory Qualifications

• 12+ years of overall Business Analysis experience
• 5+ years of Data Analysis experience with CMS & NCQA Quality Measures (Mandatory)
• 5+ years of data warehousing experience in a clinical environment
• Direct hands-on experience with CMS & NCQA projects (Required no exceptions)

Strong Experience With

• SQL
• Data Analysis
• Business Analysis
• SDLC & Agile methodologies (5+ years combined)
• Experience with data warehousing, data mapping, and cloud-based data platforms
• Clinical data experience; EMR/EHR exposure is a strong plus

Preferred Qualifications

• Former UnitedHealthcare (UHC) / UnitedHealth Group (UHG) experience
• Clinical background (RN, healthcare analyst, or similar)
• Deep expertise in CMS Quality Measures (Stars, HEDIS, etc.)
• Experience with software and data development projects in healthcare
• Experience supporting regulatory or compliance-driven analytics initiatives

Ideal Candidate Profile

• Senior-level clinical data analyst with regulatory healthcare experience
• Strong understanding of CMS & NCQA quality frameworks
• Highly detail-oriented with strong data validation skills

Comfortable working remotely with cross-functional healthcare teams