Lead Quality Data Analyst - Remote

Summary of Job Lead and develop meaningful insights, actionable analytics and applicable plans and /or corrective actions through appropriate advanced statistical and/or modeling analyses. Incorporate diverse data sources across internal and external platforms to continuously improve the plan's healthcare qualitymetric performance (HEDIS/QARR/Star/Accreditation) to drive quality improvement initiatives/projects. Identify improvement opportunities and provide guidance for needed changes. Provide support in the satisfaction of internal and external requirements in support of EmblemHealth's HEDIS/QARR metric improvement and reporting responsibility. Prepare and present analytical dashboards and data to key stakeholders to support strategic decision making. Responsibilities * Lead the development of complex and/or advanced statistical/modeling analyses of quality metrics for Medicare, State Sponsored Programs, and other populations. * Develop and maintain quality dashboards and measure profiles utilizing data visualization tools. * Analyze monthly rate reports and stratify data to identify statistically significant trends. * Perform monthly rate/impact /trending analysis and recommend corrective actions to meet quality targets. * Conduct evaluation studies and root-cause analyses to identify improvement area(s) and understanding of the marketplace. Evaluate program effectiveness for complex quality improvement projects. Provide analytical and evaluation guidance to internal department for simple projects. * Generate population or targeted profiles with frequency, categorical, and spatial analyses. * Perform exploratory and in-depth data analyses for assigned measure/population and develop complex predictive models utilizing independent variables and programming language. * Develop customized models and scenario analyses to monitor and review projected measure scores/incentive results through the year. Lead and take corrective actions to meet established goals and/or overall quality metric goals. * Create, design, and implement new analytics tools and visualizations to supplement and support decision-making for departmental activities. * Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues. * Maintain up-to-date knowledge and understanding of HEDIS/QARR/Star measure technical specifications. * Support quality specific interoperability efforts. * Support quality specific regulatory needs. * Collaborate with internal quality management teams to assist on quality improvement initiatives. * Provide analytical and technical support for design, development and maintenance of quality improvement and wellness initiatives. * Develop additional elements to prepare plan-specific and provider-specific reports/information related to quality, services, and other areas.

Qualifications * Bachelor's Degree in analytical/quantitative field including healthcare management, finance, business, mathematics, engineering, applied stats/economics, or any other related fields. * Master's Degree (Preferred) * 5 - 8+ years of relevant, professional work experience (Required) * 5+ years of experience in any analytical field (Required) * 3+ years of managed care/healthcare experience (Preferred) * Proficient in Microsoft Office - Word, PowerPoint, Excel, Access ( (Required) * Advanced experience with relational database applications - SAS, R, SQL, or others (Required) * Experience with improving/automating processes using programming languages/software - Python, VBA, R, SAS, C++, etc. (Required) * Experience with and proficient in statistical software/programs - SAS, R, Stata, Minitab or others (Required) * Experience with and proficient in data visualization tools - Power BI, Tableau (Required)) * Knowledge of HEDIS & QARR reporting processes and Medicare Stars (Preferred) * Strong communication skills - verbal, written, presentation, interpersonal (Required) Additional Information * Requisition ID: 1000002937 * Hiring Range: $77,760-$149,040