HEDIS Performance Analytics Lead

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Spearhead the creation of predictive models aimed at identifying members who are at risk of experiencing care gaps and prioritize outreach initiatives.

• Conduct advanced statistical analyses to reveal the factors influencing variations in HEDIS performance.

• Formulate segmentation strategies (by provider, population, and geography) to effectively target high-impact interventions.

• Create forecasting models to project HEDIS performance and simulate various intervention scenarios.

• Convert intricate analytical results into straightforward, actionable recommendations for both executive and operational stakeholders.

• Pinpoint the most valuable opportunities for enhancement based on their impact, feasibility, and return on investment (ROI).

• Develop frameworks to assess the effectiveness of HEDIS interventions and initiatives.

• Carry out pre/post and longitudinal analyses to measure program impact.

• Quantify financial and quality outcomes, including the effects on Stars ratings, incentive revenue, and implications for the cost of care.

• Design and manage comprehensive enterprise HEDIS performance dashboards and reporting tools.

• Collaborate with Clinical, Quality, Provider Engagement, and Operations teams to ensure analytics align with business requirements.

⛳️ Requirements

• 7-10+ years of experience in healthcare analytics, HEDIS, or quality performance enhancement.

• Strong analytical capabilities, including expertise in predictive modeling, statistical analysis, and handling large datasets.

• Proven track record of translating data into actionable insights that result in measurable outcomes.

• Proficient in data tools and programming languages (such as SQL, Python, R).

• Familiarity with data visualization tools (like 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.