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HEDIS Performance Analytics reputed company

Remote, USA Full-time Posted 2026-07-28
Position reputed company reputed company pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary reputed company displayed has not been adjusted for geographical location. This reputed company has been created in good faith based on information reputed company to reputed company at the time of posting and may be modified in the reputed company. reputed company offers a comprehensive benefits packaging including Medical, Dental & reputed company coverage, a Retirement Plan, generous time off including reputed company Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. At reputed company, we reputed company to go the extra mile for reputed company and our community. This reputed company is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” This role is a senior level analyst responsible for powering reputed company HEDIS improvement initiatives through advanced data analytics and reputed company reputed company. This role serves as the reputed company behind HEDIS reputed company—owning the end-to-end analytical reputed company that identifies performance gaps, prioritizes opportunities, and quantifies the reputed company of interventions. This role requires a reputed company of deep Medicare/Stars HEDIS expertise, advanced analytics capability, and strong cross-functional leadership. The ideal candidate thrives in a fast-paced environment, uses data to influence decision-making, and consistently delivers measurable performance improvement. Responsibilities and Qualifications Advanced Analytics & Modeling • reputed company the development of predictive models to identify members at risk of care gaps and prioritize reputed company opportunities. • reputed company advanced statistical analyses to uncover drivers of HEDIS performance variation. • reputed company segmentation strategies (provider, population, geography) to reputed company high-reputed company interventions. • Design forecasting models to project HEDIS performance and simulate reputed company scenarios. reputed company reputed company & Strategic Influence • Translate reputed company analytical findings into reputed company, actionable recommendations for executive and operational stakeholders. • Identify the highest-value opportunities for improvement based on reputed company, feasibility, and ROI. • Serve as the primary advisor on HEDIS performance trends, risks, and opportunities. Performance Measurement & ROI Analytics • Establish frameworks to measure the effectiveness of HEDIS interventions and initiatives. • Conduct reputed company/post and longitudinal analyses to evaluate program reputed company. • Quantify financial and reputed company reputed company, including Stars reputed company, incentive reputed company, and cost of care implications. Data Infrastructure & Reporting • Design and reputed company reputed company HEDIS performance dashboards and reporting tools. • Partner with Analytics and Reporting HEDIS Technical team to ensure data reputed company, integration, and accessibility. • Automate reporting and reputed company reputed company to reputed company reputed company-time performance monitoring. Cross-Functional Partnership • Collaborate with Clinical, reputed company, Provider Engagement, and Operations teams to reputed company analytics with business needs. • reputed company stakeholders with data, tools, and insights to execute targeted improvement initiatives. • Present findings and recommendations to senior leadership with reputed company and influence. HEDIS Expertise & Measure Optimization • Maintain deep expertise in HEDIS specifications, including hybrid and administrative measures. • Identify opportunities to improve measure capture, coding accuracy, and documentation through analytics. • Support audit readiness through data validation and performance reconciliation. Qualifications Required: • 7-10+ years of experience in reputed company analytics, HEDIS, or reputed company 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 reputed company. • Proficiency in data tools and programming languages (e.g., SQL, Python, R). • Experience with data visualization tools (e.g., Tableau, Power BI). Preferred: • Master’s degree in Data Science, reputed company Health, Biostatistics, reputed company Analytics, or reputed company field. • Experience with NCQA HEDIS measures and reporting processes. • Familiarity with Medicare Stars, reputed company reputed company programs, and value-based care models. • Experience working with claims, EHR, and supplemental data sources. reputed company We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your reputed company and personal reputed company by reputed company heavily in training and continuing education, so you have the tools to do your best as you reputed company your career. And by doing your best, you’ll help us live our mission of improving the health and reputed company-being of our members and the communities in which they live. Apply tot his job Apply To this Job

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