Senior HEDIS Analytics & Performance Lead

Capital Blue Cross; United States; On-site; USD 100,000 - 150,000; Full time

Job summary

Capital Blue Cross is seeking a senior analyst to power HEDIS improvement initiatives through advanced data analytics and insight generation. You will own end-to-end analytical frameworks, identify performance gaps, prioritize opportunities, and quantify intervention impact.

The role requires Medicare/Stars HEDIS expertise, advanced analytics, and strong cross-functional leadership. The ideal candidate thrives in a fast-paced environment, uses data to influence decisions, and delivers measurable

Qualifications

• 7-10+ years of experience in healthcare analytics, HEDIS, or quality performance improvement.
• Advanced analytical skills, including predictive modeling, statistical analysis, and large datasets.
• Ability to translate data into actionable insights that drive measurable outcomes.
• Proficiency in data tools and programming languages (SQL, Python, R).
• Experience with data visualization tools (Tableau, Power BI).

Responsibilities

• Lead development of predictive models to identify members at risk of care gaps and prioritize outreach opportunities.
• Perform advanced statistical analyses to uncover drivers of HEDIS performance variation.
• Develop segmentation strategies (provider, population, geography) to target high-impact interventions.
• Design forecasting models to project HEDIS performance and simulate intervention scenarios.
• Translate complex analytical findings into clear, actionable recommendations for executives and stakeholders.
• Identify high-value opportunities based on impact, feasibility, and ROI.
• Serve as the primary advisor on HEDIS performance trends, risks, and opportunities.
• Establish frameworks to measure effectiveness of HEDIS interventions and initiatives.
• Conduct pre/post and longitudinal analyses to evaluate program impact.
• Quantify financial and quality outcomes, including Stars impact and cost of care implications.
• Design and oversee enterprise HEDIS performance dashboards and reporting tools.
• Partner with Analytics and Reporting HEDIS Technical team to ensure data quality and accessibility.
• Automate reporting and insight generation for real-time performance monitoring.
• Collaborate with Clinical, Quality, Provider Engagement, and Operations teams to align analytics with business needs.
• Enable stakeholders with data, tools, and insights to drive improvement initiatives.
• Present findings and recommendations to senior leadership with clarity and influence.
• Maintain deep expertise in HEDIS specifications and identify opportunities to improve measure capture and documentation.
• Support audit readiness through data validation and performance reconciliation.

Skills

HEDIS analytics

Predictive modeling

SQL

Python/R

Tableau/Power BI

Education

Master's degree

Tools

SQL

Python

R

Tableau

Power BI

Job description

Capital Blue Cross is seeking a senior analyst to power HEDIS improvement initiatives through advanced data analytics and insight generation. You will own end-to-end analytical frameworks, identify performance gaps, prioritize opportunities, and quantify intervention impact.

The role requires Medicare/Stars HEDIS expertise, advanced analytics, and strong cross-functional leadership. The ideal candidate thrives in a fast-paced environment, uses data to influence decisions, and delivers measurable