Company Statement

EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.

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Lead Quality Data Analyst - Remote

🔍 New York, New York

💼: EmblemHealth

📅   : Feb 13, 2026 Post Date

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)

Security Disclosure

If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.

Pay Disclosure

At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.

EEOC Statement

We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.

Sponsorship Statement

At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.