HEDIS Performance Analytics Lead

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