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Principal Quality Analytics Lead

Data ScientistData ScientistFull TimeRemoteSeniorTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

53 days ago

Salary

$133.2K - $180.9K / year

Seniority

Senior

Bachelor Degree7 yrs expEnglishSQLTableau

Job Description

Principal Quality Analytics Lead

Lumeris

• Design, build, and maintain CMS-aligned Stars/HEDIS analytic assets, including dashboards, data extracts, recurring performance views, and executive-ready reporting products. • Translate measure specifications (numerator, denominator, exclusions) into auditable analytic logic and develop member-, provider-, and measure-level views to guide Quality Improvement actions. • Analyze multi-source data (quality, medical, pharmacy, clinical) to establish baselines, detect trends, uncover root causes of performance gaps, and distinguish data issues from operational issues. • Partner with Quality Improvement, Clinical, Pharmacy, and Operations stakeholders to prioritize high-impact opportunities and convert analytic insights into intervention targeting, workflow integration, and measurable gap closure. • Automate and scale recurring quality reporting to reduce manual effort through scalable dashboards, reusable SQL, documented logic, and repeatable processes. • Create and manage validation routines, QA checks, and reconciliation processes to ensure quality reporting is accurate, trusted, reproducible, and audit-ready. • Translate complex technical and measure logic into clear, decision-ready performance narratives for non-technical stakeholders and health plan leadership. • Serve as a senior subject matter expert on Stars, HEDIS, quality measure reporting, and health plan operations, advising on the workflow integration of analytic insights.

Job Requirements

  • Bachelor's degree in Mathematics, Computer Science, Epidemiology, Public Health, Healthcare Administration, Data Analytics, or a related field; equivalent experience may be considered.
  • 7+ years of healthcare analytics experience, with direct experience in Medicare Advantage Stars, HEDIS, quality measures, and health plan performance analytics.
  • Hands-on experience writing complex SQL and extracting data from large, multi-layered health plan data environments.
  • Experience building dashboards, recurring reports, or automated reporting processes using Tableau, Power BI, or similar business intelligence tools.
  • Experience with Stars cut points, HEDIS specifications, CAHPS, medication adherence, clinical quality workflows, or care gap closure.
  • Ability to translate Stars/HEDIS measure logic into analytic rules, including numerators, denominators, exclusions, and opportunity sizing.
  • Experience working with healthcare datasets such as claims, eligibility, provider, pharmacy, or clinical data.
  • Demonstrated ability to self-direct analyses, manage ambiguity, structure complex problems, and deliver actionable insights with limited direction.
  • Experience using AI-enabled analytics, automation, or natural language tools to accelerate insight generation.
  • Strong communication skills with the ability to explain technical concepts and recommended actions to non-technical stakeholders.
  • Advanced degree in Public Health, Epidemiology, Analytics, Computer Science, Healthcare Administration, or a related field.

Benefits

  • Medical, Vision and Dental Plans
  • Tax-Advantage Savings Accounts (FSA & HSA)
  • Life Insurance and Disability Insurance
  • Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
  • Employee Assistance Program
  • 401k with company match
  • Employee Resource Groups
  • Employee Discount Program
  • Learning and Development Opportunities
  • And much more...

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