Remote Senior Analyst, Digital HEDIS & Quality Analytics

EmblemHealth; New York, Northern (NY, KY); Hybrid; USD 68,000 - 119,000; Full time

Job summary

EmblemHealth seeks a Sr. Analyst to support the digital HEDIS strategy through analysis, dashboards, and predictive modeling. You will automate manual reporting, govern clinical data sources, and partner with IT and external vendors to enhance quality metrics across STAR programs.

You will prepare analytical dashboards for stakeholders, identify data improvement opportunities, and drive end-to-end analytics projects in a remote work setting within the U.S.

Qualifications

• Bachelor’s degree in analytical/quantitative field (healthcare management, finance, business, math, engineering, applied stats/economics or related).
• Master’s degree preferred.
• 4–6+ years of relevant, professional work experience (Required).
• 3+ years of experience in managed care/healthcare analytics (Required).
• Advanced knowledge of HEDIS and Medicare Stars with electronic clinical quality measures and related data sources (Required).
• Proficient in Microsoft Office (Word, PowerPoint, Excel, Access) (Required).
• Advanced experience with relational databases (SAS, R, SQL, or others) (Required).
• Experience with automating processes using Python, VBA, R, SAS, C++, or others (Required).
• Experience with statistical software (SAS, R, Stata, Minitab or others) (Preferred).
• Experience with data visualization tools (Power BI, Tableau) (Required).
• Demonstrated self-starter with ability to develop projects end to end independently (Required).

Responsibilities

• Implement reporting, reconciliation workflows and document processes.
• Conduct medical trend studies related to quality initiatives.
• Identify data improvement opportunities via HEDIS/QARR/Star reports and data outputs.
• Collaborate with IT and vendors to plan digital readiness, including for FHIR.
• Source new clinical data ingestion from data aggregators, EHRs, HIEs, etc.
• Perform data collection, mining and reporting for internal and external customers.
• Develop complex statistical/modeling analyses of quality metrics for Medicare and other populations.
• Maintain automated quality dashboards and measure profiles using visualization tools.
• Provide analytical support for design, development, and maintenance of quality initiatives; build self-service reports.
• Analyze business problems related to member quality experience and STARS rating.
• Present findings to internal partners and drive further analysis.

Skills

HEDIS knowledge

Medicare Stars

Self-starter

Data analysis

Education

Bachelor’s Degree in analytical/quantitative field

Master’s Degree preferred

Tools

SAS

R

SQL

Microsoft Office

Power BI

Tableau

Python

VBA

C++

Job description

EmblemHealth seeks a Sr. Analyst to support the digital HEDIS strategy through analysis, dashboards, and predictive modeling. You will automate manual reporting, govern clinical data sources, and partner with IT and external vendors to enhance quality metrics across STAR programs.

You will prepare analytical dashboards for stakeholders, identify data improvement opportunities, and drive end-to-end analytics projects in a remote work setting within the U.S.