Senior HEDIS, Stars & ACO Data Analytics Manager

CINQCARE; Washington (District of Columbia); On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

401(k) with Employer Match

Comprehensive Medical Plan

Dental & Vision Coverage

Life Insurance

Paid Time Off

CME Allowance

Commuter Benefits

Mileage Reimbursement

Job summary

Grace at Home in Washington, DC is seeking a Manager of HEDIS, Stars & ACO Data Analytics to lead quality measurement across product lines. This role ensures regulatory compliance, audit readiness, and timely submissions per NCQA, CMS, and EOHHS.

The Manager drives quality performance improvement, oversees data integration, and works in a matrix with analytics teams. 5+ years in healthcare analytics and HEDIS leadership are expected.

Qualifications

• Education and experience in health, informatics, data science, or related field.
• Experience with Excel, PowerBI, Tableau; SAS, SQL preferred.
• 5+ years in healthcare analytics; 5-10 years of HEDIS leadership experience.
• Experience leading HEDIS audits.
• Strong knowledge of HEDIS/QRS specs, Medicare Stars measures, and healthcare data systems.

Responsibilities

• Establish and execute comprehensive operational work plans for HEDIS, Medicare Stars, and ACO quality performance.
• Lead the full HEDIS lifecycle: planning, data collection, validation, rate calculation, submission, and audit.
• Ensure compliance with NCQA, CMS, Medicaid, MMP (DSNP), and ACO requirements.
• Conduct performance analysis and root cause reviews to improve quality scores and financial incentives.
• Present results and performance insights to leadership and quality committees.
• Lead initiatives to expand and optimize electronic clinical data exchange with provider EHRs, laboratory systems, and the State immunization registry.
• Improve data integrity, reporting accuracy, and operational efficiency.
• Identify and resolve data integrity issues in partnership with data governance and analytics teams.
• Partner with internal teams and external stakeholders to enhance data systems and quality outcomes.
• Manage HEDIS software vendors and coordinate audits.
• Lead RFPs, contract oversight, and audit coordination.
• Monitor specification updates and ensure submission compliance.
• Lead, mentor, and develop cross-functional analytic and clinical staff.
• Ensure training, cross-training, and timely completion of all deliverables.
• Manage performance, accountability, and cross-functional team development.
• Collaborate with Operations, Clinical, Network, Finance, Analytics, Practice Transformation, Care Management, Pharmacy, and Social Care.

Skills

PowerBI

Tableau

Excel

PowerPoint

SAS

SQL

Analytical thinking

Communication skills

Team leadership

Education

Bachelor's degree in health/informatics/data science

Master's degree preferred (MBA/MPH/MS)

Tools

SAS

SQL

PowerBI

Tableau

Microsoft Office

Job description

Grace at Home in Washington, DC is seeking a Manager of HEDIS, Stars & ACO Data Analytics to lead quality measurement across product lines. This role ensures regulatory compliance, audit readiness, and timely submissions per NCQA, CMS, and EOHHS.

The Manager drives quality performance improvement, oversees data integration, and works in a matrix with analytics teams. 5+ years in healthcare analytics and HEDIS leadership are expected.