Data Analyst - Remote

Primary Responsibilities

• Prepare for and actively participate in the annual NCQA HEDIS audit process, including gathering documentation, responding to auditor requests, validating measure logic, and supporting audit deliverables
• Monitor, analyze, and trend HEDIS and quality performance data on a monthly basis to identify performance gaps, emerging trends, and opportunities for improvement
• Develop and maintain dashboards, PivotTables, and reports to support quality programs, HEDIS performance, Star Ratings, PIP initiatives, and other clinical quality measures
• Utilize SQL to extract, validate, analyze, and interpret healthcare data from multiple data sources to support reporting, measure monitoring, and operational decision-making
• Collaborate with internal business partners, provider groups, healthcare informatics teams, and leadership to ensure data accuracy and support quality improvement initiatives
• Prepare and update executive-level presentations, reports, and visualizations that communicate performance results, key findings, risks, and strategic recommendations
• Provide actionable insights and recommendations to leadership regarding areas requiring focus, intervention, or performance improvement
• Support the development and implementation of supplemental data processes, reporting enhancements, and data validation activities
• Participate in cross-functional meetings and workgroups to provide subject matter expertise related to HEDIS measures, quality reporting, and healthcare data analytics
• Assist with ad hoc analysis, special projects, and strategic initiatives that support organizational quality goals and regulatory requirements

Required Qualifications

• 2+ years of experience writing and maintaining SQL queries for data extraction, analysis, and reporting
• 2+ years of experience working with healthcare-related data, including analysis, validation, and performance monitoring
• Intermediate level proficiency in Microsoft Excel, including experience with PivotTables, dashboards, data analysis, and reporting
• Proven analytical and communication skills, with the ability to translate complex data into meaningful insights and present findings to leadership
• Demonstrate ability to support data-driven decision-making and quality improvement initiatives
• Proven excellent organizational skills with attention to detail and accuracy

Preferred Qualifications

• HEDIS experience
• Proven knowledge of HEDIS measures, quality programs, and health plan rating methodologies (e.g., Star Ratings)
• Demonstrated familiarity with NCQA standards, HEDIS audits, and regulatory reporting requirements
• Proven knowledge of Medicaid quality reporting and state-specific reporting requirements
• Experience managing, validating, or integrating supplemental data feeds to support quality measurement and reporting
• Proven understanding of healthcare quality improvement programs, population health, and performance measurement