Senior Digital HEDIS & Quality Analytics Lead

EmblemHealth; New York (NY); On-site; USD 77,000 - 149,000; Full time

Job summary

EmblemHealth is seeking a senior data analytics leader to drive the digital HEDIS strategy. You will optimize data governance, automate reporting, and build dashboards supporting HEDIS/QARR/Star metrics.

The role requires advanced analytics, vendor coordination, and cross-functional partnership to improve data quality and clinical insights. You will lead trend studies, develop automated workflows, and present actionable insights to stakeholders for strategic decisions.

Qualifications

• Bachelor’s Degree in analytical/quantitative field incl. healthcare management, finance, business, statistics, engineering or related
• Master’s Degree preferred
• 5–8+ years of relevant, professional work experience
• 5+ years in managed care/healthcare analytics
• Advanced knowledge of HEDIS and Medicare Stars with electronic measures
• Proficient in Microsoft Office (Word, PowerPoint, Excel, Access)
• Advanced experience with relational databases (SAS, R, SQL)
• Experience with automation using Python, VBA, R, SAS or similar
• Experience with data visualization tools (Power BI, Tableau)
• Strong communication skills and ability to lead end-to-end projects

Responsibilities

• Lead implementation of digital HEDIS strategy and data governance
• Develop automated reporting and dashboards for quality metrics
• Perform data mining and reporting for stakeholders
• Collaborate with IT, vendors, providers to ensure digital readiness
• Conduct medical trend studies related to quality initiatives
• Develop complex statistical analyses for Medicare and Star measures
• Build self-service reports for the quality department
• Present findings to internal partners and drive decisions
• Improve data capabilities and data ingestion from multiple sources
• Support quality improvement initiatives with data-driven insights
• Oversee data intake, quality assurance, and measurement profiles

Skills

Healthcare analytics

HEDIS/Stars

SQL

R

SAS

Python

Data visualization

Power BI

Tableau

Excel

Communication

Education

Bachelor’s Degree

Master’s Degree preferred

Tools

SAS

R

SQL

Power BI

Tableau

Job description

EmblemHealth is seeking a senior data analytics leader to drive the digital HEDIS strategy. You will optimize data governance, automate reporting, and build dashboards supporting HEDIS/QARR/Star metrics.

The role requires advanced analytics, vendor coordination, and cross-functional partnership to improve data quality and clinical insights. You will lead trend studies, develop automated workflows, and present actionable insights to stakeholders for strategic decisions.