EmblemHealth · 5 hours ago
Senior Quality Data Analyst - Remote
EmblemHealth is seeking a Senior Quality Data Analyst to support the Quality Management department in developing and maintaining a monitoring and reporting structure for data reports and analysis related to various healthcare initiatives. The role involves analyzing data, creating reports, and providing insights to drive quality and performance improvements in Medicare Stars and Medicaid QIA programs.
Non ProfitWellnessProperty & Casualty InsuranceInsurance
Responsibilities
Analyze monthly rate reports and stratify data to identify statistically significant trends
Evaluate effectiveness of complex quality improvement projects established for all Medicare and state-sponsored programs
Create reports to track, monitor and report on provider and network-wide quality performance, including performance towards Medicare Stars and NYSDOH quality goals
Perform exploratory and in-depth data analyses for assigned measure/population and develop complex predictive models utilizing independent variables and programming language
Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues
Provide analytical and technical support in the design, development and maintenance of quality improvement and wellness-based initiatives
Work with various teams in Quality Management to develop needed tools to track, trend and directly impact measures results related to Quality Scores
Perform regular rate/impact /trending analysis and recommend corrective actions to meet quality targets
Maintain up-to-date knowledge and understanding of HEDIS/QARR/Star measure technical specifications
Support quality specific interoperability efforts
Support quality specific regulatory needs
Qualification
Required
Bachelor's Degree in an analytical/quantitative field (healthcare management, finance, business, mathematics, engineering, applied stats/economics, or related)
4 – 6+ years of relevant, professional work experience in an analytical role
Proficient in MS Office - Word, PowerPoint, Excel, Access
Advanced experience with relational database applications - SAS, R, SQL, or others
Experience with improving or automating processes using programming languages/software - Python, VBA, R, SAS, C++, etc
Experience with and proficient in statistical software/programs - SAS, R, Stata, Minitab or others
Strong communication skills - verbal, written, presentation, interpersonal
Preferred
Master's Degree
2+ years of managed care/healthcare experience
Familiarity with Business Intelligence tools - Tableau, Power BI
Knowledge of HEDIS and Medicare Stars reporting processes
Company
EmblemHealth
EmblemHealth is an insurance and wellness company that offers health benefits to consumers, employers, and government purchasers.
Funding
Current Stage
Late StageRecent News
Behavioral Health Business
2026-01-11
2025-12-10
bloomberglaw.com
2025-12-06
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