Remote Quality Analytics Specialist – HEDIS & Records

Online Consumer Panels America; Dundalk (MD); Hybrid; USD 64,000 - 126,000; Full time

Job summary

CareFirst BlueCross BlueShield is seeking a Quality Analyst to support HEDIS, Stars, and regulatory quality initiatives. The role focuses on medical record retrieval, data analysis, and audit readiness to improve population health outcomes across lines of business.

The successful candidate will have 3+ years of experience in healthcare data analysis, knowledge of HEDIS/NCQA, and proficiency with SQL, Python or R, and Excel.

Qualifications

• Bachelor's degree in population health, public health, health policy, or a related field; or equivalent experience.
• 3 years of professional experience in a business/healthcare setting; progressive responsibility.

Responsibilities

• Coordinate medical record retrieval, provider outreach, intake, and documentation for HEDIS, Stars, and regulatory reporting.
• Perform medical record abstraction and quality reviews per HEDIS/NCQA specifications.
• Support audit readiness and data integrity activities across multiple programs.
• Analyze workflow, quality, and measurement trends to identify improvement opportunities.
• Maintain knowledge of HEDIS, NCQA, CMS standards and HIPAA requirements.

Skills

Data analytics

SQL

Python/R

Excel

Healthcare data

Education

Bachelor's Degree in Population Health or related field

Tools

Cotiviti

Inovalon

Reveleer

Job description

CareFirst BlueCross BlueShield is seeking a Quality Analyst to support HEDIS, Stars, and regulatory quality initiatives. The role focuses on medical record retrieval, data analysis, and audit readiness to improve population health outcomes across lines of business.

The successful candidate will have 3+ years of experience in healthcare data analysis, knowledge of HEDIS/NCQA, and proficiency with SQL, Python or R, and Excel.