Senior Analyst – Quality Management

This is a fully remote position, open to applicants in Alabama, +37 more states.

📋 Description

• Create targeting lists for members based on business-defined criteria, measure-level gap information, claims data, and member characteristics.

• Assess the effectiveness of outreach initiatives, engagement strategies, and overall quality programs.

• Perform root-cause analysis for data-related issues within the business.

• Integrate, validate, and analyze datasets related to claims, enrollment, providers, pharmacy, clinical information, and HEDIS.

• Collaborate with business owners across functions to gather requirements and convert business needs into analytical solutions.

• Develop, maintain, and improve dashboards and scorecards for health plans.

• Present analysis of measure performance to senior leadership.

• Ensure the accuracy, quality, and integrity of reports.

• Deliver ad-hoc and scheduled reporting requirements punctually.

• Assist with special projects as needed.

⛳️ Requirements

• A minimum of 5 years of experience in healthcare analytics, data analysis, reporting, or a related field.

• Familiarity with HEDIS and Stars measures.

• Proven ability to independently manage complex analytical projects.

• Experience with healthcare claims, member data, provider, and clinical information.

• Proficient in conducting root cause analysis.

• Advanced skills in Microsoft Excel.

• Strong verbal and written communication abilities.

• Bachelor's degree in health informatics or a related discipline, or an equivalent combination of education and experience (REQUIRED).

• Preferred experience with SQL queries.

• Master’s Degree is preferred.

🏝️ Benefits

• Bonus, commission, or short-term incentive program from CVS Health in addition to base salary.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision care coverage.

• Paid time off.

• Options for retirement savings.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being.