Quality Measures Engineer

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

📋 Description

• Assess HEDIS, eCQM, and PQA measure specifications to create and verify numerator, denominator, and exclusion logic.

• Assist the development team in constructing HEDIS and HEDIS-like quality measures on a Tableau analytics platform.

• Utilize Epic Clarity/Caboodle data and adjudicated paid claims data to aid in measure development and validation.

• Detect and address logic discrepancies, specification uncertainties, and data quality concerns throughout measure sets.

• Confirm measure outputs against specification requirements to guarantee precision and compliance.

• Collaborate with analytics, clinical, and technical stakeholders to ensure measure logic aligns with operational and reporting demands.

• Facilitate ongoing measure maintenance, updates, and expansion as the platform evolves.

• Interpret HEDIS and HEDIS-like quality measure specifications, translating them into clear and precise logic for developers.

⛳️ Requirements

• Practical experience with HEDIS measure specifications, including the development of numerator, denominator, and exclusion logic.

• Required experience working with adjudicated paid claims data from payers.

• Strong grasp of value-based care metrics, population health analytics, and quality measure frameworks.

• Familiarity with eCQM and PQA measure sets.

• Capability to convert intricate measure specifications into clear, actionable logic for a technical development team.

• Excellent analytical and communication abilities across clinical, operational, and technical audiences.

• Must be eligible to work in the U.S. without sponsorship.

• Preferred experience with Epic Clarity or Caboodle.

• Preferred experience working within or supporting a Tableau analytics environment.

• Background in supporting VBC programs such as ACO, Medicare Advantage Stars, or MSSP is preferred.

• Familiarity with NCQA HEDIS technical specifications and value sets (VSAC) is preferred.

• Experience in a consulting or advisory role supporting population health or quality analytics initiatives is preferred.

🏝️ Benefits

• Health insurance

• Dental insurance

• Vision insurance

• 401(k)

• Great culture/working environment