Lead: Digital HEDIS Quality Analytics & Automation

EmblemHealth; New York (NY); On-site; USD 120,000 - 180,000; Full time

Job summary

EmblemHealth seeks a senior analytics lead to drive the quality department's digital HEDIS strategy and data governance. You will oversee automated reporting, trend analyses, and data ingestion from diverse sources to support Star metrics and NCQA readiness.

Working with IT and external vendors, you will develop advanced statistical models for Medicare and other populations, and deliver self-service dashboards to inform strategic decisions for stakeholders.

Qualifications

• Bachelor’s degree in analytical/quantitative field (healthcare, finance, math, engineering, economics).
• Master’s degree preferred.
• 5–8+ years of relevant professional work experience (Required).
• 5+ years of experience in managed care/healthcare analytics (Required).
• Advanced knowledge of HEDIS and Medicare Stars, including electronic quality measures (Required).
• Proficient in Microsoft Office (Word, PowerPoint, Excel, Access) (Required).
• Advanced experience with relational database applications (SAS, R, SQL, or others) (Required).
• Experience with automating processes using programming languages (Python, VBA, R, SAS, or others) (Required).
• Experience with data visualization tools (Power BI, Tableau) (Required).
• Demonstrated self-starter with end-to-end project development (Required).

Responsibilities

• Lead the implementation of the quality department digital HEDIS strategy and analytics.
• Develop, automate, and manage reporting workflows and data governance for HEDIS/QARR/Star metrics.
• Lead medical trend studies related to quality initiatives.
• Identify data improvement opportunities from HEDIS/QARR/Star outputs and data issues.
• Collaborate with IT and vendors to ensure digital readiness (FHIR).
• Generate and present analytical dashboards to stakeholders for strategic decisions.
• Develop advanced statistical analyses for Medicare, State Programs, and other populations.
• Create automated quality dashboards and measure profiles using visualization tools.
• Guide design and maintenance of quality improvement initiatives and self-service reports.
• Assist quality teams on improvement initiatives and end-to-end projects.

Skills

HEDIS/Medicare Stars

SQL

SAS

R

Python

Power BI/Tableau

Data visualization

Data governance

Healthcare analytics

MS Office

Education

Bachelor’s degree in analytical/quantitative field

Master’s degree preferred

Tools

SAS

R

SQL

Tableau

Power BI

Job description

EmblemHealth seeks a senior analytics lead to drive the quality department's digital HEDIS strategy and data governance. You will oversee automated reporting, trend analyses, and data ingestion from diverse sources to support Star metrics and NCQA readiness.

Working with IT and external vendors, you will develop advanced statistical models for Medicare and other populations, and deliver self-service dashboards to inform strategic decisions for stakeholders.