Senior Quality & Population Health Analyst (Remote)

CareFirst BlueCross BlueShield; Baltimore (MD); Hybrid; USD 72,000 - 144,000; Full time

Job summary

CareFirst BlueCross BlueShield seeks a Senior Quality Analyst to define, measure, and analyze population health initiatives, driving industry‑leading outcomes at the population level. You will mentor peers and ensure alignment with the organization's vision for quality and member experience.

We are looking for an experienced professional to live and work remotely from within the greater Baltimore/Washington metropolitan area, with periodic visits to CareFirst locations for meetings and training.

Qualifications

• Bachelor's Degree in population health, public health, healthcare administration, business administration, health policy, economics, statistics, mathematics, data science, or a related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
• RN‑BC - Certified General Nursing Practice is preferred.
• 5 years professional experience in a business environment (public health, health insurance, management consulting fields preferred).
• Direct experience with HEDIS, NCQA accreditation, CAHPS, quality programs, Stars, quality improvement, or related quality activities in a healthcare setting is preferred.

Responsibilities

• Act as a senior SME in HEDIS, population health, measurement science, NCQA accreditation, quality programs, Stars, medical record review, and quality improvement.
• Lead and support complex medical record retrieval, provider outreach, intake, routing, upload, documentation, abstraction, and quality reviews for HEDIS projects and related initiatives.
• Analyze and evaluate workflow outcomes, retrieval progress, data integrity, and quality results; produce actionable reports and recommendations for improvement.
• Prioritize and operationalize quality improvement opportunities, standardize retrieval and documentation workflows, and support cross‑functional collaboration.
• Mentor team members, develop SOPs and training materials, and assist with special projects and cross‑functional initiatives.

Skills

Population health

Quality analytics

Data analysis

Mentoring

Project management

Education

Bachelor's Degree in population health / related field

RN-BC Certification

Tools

SQL

Python

R

Job description

CareFirst BlueCross BlueShield seeks a Senior Quality Analyst to define, measure, and analyze population health initiatives, driving industry‑leading outcomes at the population level. You will mentor peers and ensure alignment with the organization's vision for quality and member experience.

We are looking for an experienced professional to live and work remotely from within the greater Baltimore/Washington metropolitan area, with periodic visits to CareFirst locations for meetings and training.