Principal Quality Analytics Lead
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Principal Quality Analytics Lead at Lumeris focused on designing and operationalizing quality analytics to enhance Medicare Advantage Stars performance. Collaborating with cross-functional teams for impactful healthcare insights and improvements.
Responsibilities:
- 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.
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...
Similar Jobs
Principal Pharmacy Analytics Lead
Design and operationalize pharmacy performance analytics to improve medication adherence and drug management. Collaborate with various stakeholders to enhance pharmacy objectives and insights.
Data Scientist, Customer Experience
Data Scientist enhancing product and operational strategy focused on customer experience for Whatnot. Generating insights and driving experimentation across teams to improve user satisfaction.
Data Scientist
Principal Data Scientist designing and implementing AI systems for business decision making. Collaborating with various teams to provide innovative data solutions.
Data Science and Analytics Analyst
Join TransUnion as a Data Analyst to develop your skills in data analytics. Collaborate in a team-oriented environment to contribute to impactful business initiatives.
Data Scientist
Data Scientist focusing on clinical data acquisition and integration for Aetna's quality measures. Developing models and partnering with stakeholders to produce insights and dashboards.
Lead Data Scientist – Autonomous Goal Management
Lead Data Scientist focusing on autonomous goal management and AI solutions at Humana. Collaborating with cross-disciplinary teams to innovate healthcare through AI technologies.
Senior Data Scientist, Population Health
Senior Data Scientist at Geisinger, leading data science initiatives to enhance healthcare outcomes. Mentoring junior scientists and collaborating with clinical leaders for impactful decision-making.
Senior AI Data Scientist
Senior AI Data Scientist developing Data Science & ML algorithms for real-world business problems across the team.blue group. Requires strong analytical and programming skills with a focus on innovation.
Lead Data Scientist
Lead Data Scientist driving Unobravo's data science and machine learning strategy for improving mental health support outcomes. Collaborate across teams to create actionable insights and scalable ML solutions.
Staff Data Scientist – Experimentation & Measurement
Staff Data Scientist designing and interpreting experiments to influence PlayStation's products and marketing decisions. Collaborating with cross-functional teams to embed experimentation in development cycles.
Data Scientist, Predictive Analyst – Mid Level
Data Scientist Predictive Analyst delivering predictive analytics and insights for Auto and Home actuarial teams. Collaborating on Python tool updates and advanced statistical modeling.
Data Scientist
AI & Data – Data Science Developer at IRIUM. Responsible for creating AI models and performing data analysis within a remote setup in Spain.
Global Data Manager
Global Data Manager overseeing clinical data science workstreams and ensuring quality deliverables. Collaborating across teams to optimize data management strategies and drive clinical trial success.
Head of Data
Head of Data responsible for managing data lifecycle and ensuring data quality for luxury IQ platform. Leading a 6-person team to build AI data products with external customers in mind.
Director, Data Science
Director of Data Science at DuckDuckGo driving product and business impact with a remote team. Mentoring data scientists and guiding impactful projects in data science.
Cientista de Dados Sênior
Senior Data Scientist designing and building mathematical/statistical solutions for business needs. Leading projects autonomously and mentoring junior team members.
Data Science Specialist – Feature Store & ML Platform
Data Science Specialist at Compass UOL leading Feature Store capabilities development and implementing efficient data processing. Requires expertise in ML platforms and AWS services.
Data Science Enablement Specialist – ML Platform, MLOps
Data Science Enablement Specialist managing ML teams' adoption of advanced platform solutions. Collaborating on migration processes and providing technical enablement documentation.
Senior Epic Data Scientist
Senior Data Scientist developing innovative solutions through data analysis for healthcare. Collaborating on projects and supporting clinical information systems.
International Analytics Lead
International Analytics Lead driving data systems implementation for Khan Academy’s mission to provide free education. Collaborating with country teams, enhancing analytics practices across diverse regions.