All jobs

HEDIS Performance Analytics Lead

100% Remote Full-time Open now

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

Apply tot his job Apply To this Job

You might also like

Insurance Verification Specialist Texas or Oklahoma residents

100% Remote Full-time

[Remote] Senior Abstractor, HEDIS/Quality Improvement (Remote)

100% Remote Full-time

HEDIS Reviewer - RN/LPN/LVN (100% Remote)

100% Remote Full-time

Insurance Verification Rep - PENN Presbyterian Medical Center - Remote

100% Remote Full-time

[Hiring] Insurance Verification Associate @Pearl

100% Remote Full-time

[Hiring] Insurance Eligibility Verification Specialist @Pinnacle Treatment Brand

100% Remote Full-time

Medical Coder – Virtual Clinic (AWV & HEDIS Gap Closure) - Remote

100% Remote Full-time

Medical Virtual Assistant (Insurance Verification & Authorization Specialist)

100% Remote Full-time

Remote Insurance Claim Verifier – Entry Level

100% Remote Full-time

[Remote] Representative II, Customer Service - Insurance Verification

100% Remote Full-time

Experienced Customer Service Representative – Online Chat Support for arenaflex (Work from Home)

100% Remote Full-time

Enterprise Account Executive – UK

100% Remote Full-time

Experienced Customer Service Representative – Remote Opportunity to Deliver Exceptional Arenaflex Customer Experiences

100% Remote Full-time

Senior Customer Service Representative - Remote Healthcare Solutions Specialist

100% Remote Full-time

Experienced Data Entry Specialist – Remote Opportunity with arenaflex

100% Remote Full-time

Experienced Data Entry Specialist (Work From Home) – Aviation Industry Data Management

100% Remote Full-time

Aftermarket Sales Representative - Great Lakes

100% Remote Full-time

Physician Assistant (Inpatient) - Otolaryngology

100% Remote Full-time

Experienced Remote-Live Chat Agent – Crisis Intervention and Support Specialist at arenaflex

100% Remote Full-time

Virtual Bookkeeper – For Small Businesses

100% Remote Full-time