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HEDIS Performance Analytics Lead

Remote role Full-time Open position

Job Description:

  • Lead the 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 executive and operational stakeholders
  • Identify the highest-value opportunities for improvement based on impact, feasibility, and ROI
  • Establish frameworks to measure the effectiveness of HEDIS interventions and initiatives
  • Conduct pre/post and longitudinal analyses to evaluate program impact
  • Quantify financial and quality outcomes, including Stars impact, incentive revenue, and cost of care implications
  • Design and oversee enterprise HEDIS performance dashboards and reporting tools
  • Collaborate with Clinical, Quality, Provider Engagement, and Operations teams to align analytics with business needs

Requirements:

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

Benefits:

  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off
  • Holidays
  • Volunteer time off
  • Incentive Plan
  • Tuition Reimbursement

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