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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Senior Quality Data Analyst - Remote
- 💼
- EmblemHealth
- 📅
- Feb 13, 2026 Post Date
Summary of Job
Support the Quality Management department in the development and maintenance of a monitoring and reporting structure for data reports and analysis related to the HEDIS-QARR project, pharmacy adherence initiatives, and other performance improvement initiatives related to Medicare Stars and Medicaid QIA. Provide analysis of HEDIS-QARR projects, pharmacy adherence initiatives, and other performance improvement initiatives related to Medicare Stars and Medicaid QIA. Develop meaningful insights and actionable analytics using advanced statistical and/or modeling analyses to drive quality and STARS performance.
Responsibilities
- Analyze monthly rate reports and stratify data to identify statistically significant trends.
- Evaluate effectiveness of complex quality improvement projects established for all Medicare and state-sponsored programs.
- Create reports to track, monitor and report on provider and network-wide quality performance, including performance towards Medicare Stars and NYSDOH quality goals.
- Perform exploratory and in-depth data analyses for assigned measure/population and develop complex predictive models utilizing independent variables and programming language.
- Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues.
- Provide analytical and technical support in the design, development and maintenance of quality improvement and wellness-based initiatives.
- Work with various teams in Quality Management to develop needed tools to track, trend and directly impact measures results related to Quality Scores.
- Perform regular rate/impact /trending analysis and recommend corrective actions to meet quality targets.
- Maintain up-to-date knowledge and understanding of HEDIS/QARR/Star measure technical specifications.
- Support quality specific interoperability efforts.
- Support quality specific regulatory needs.
Qualifications
- Bachelor’s Degree in an analytical/quantitative field (healthcare management, finance, business, mathematics, engineering, applied stats/economics, or related).
- Master’s Degree (Preferred)
- 4 – 6+ years of relevant, professional work experience in an analytical role (Required)
- 2+ years of managed care/healthcare experience (Preferred)
- Proficient in MS Office - Word, PowerPoint, Excel, Access (Required)
- Advanced experience with relational database applications - SAS, R, SQL, or others (Required)
- Experience with improving or 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)
- Familiarity with Business Intelligence tools - Tableau, Power BI (Preferred)
- Knowledge of HEDIS and Medicare Stars reporting processes (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.