Mgr, Strategic Analytics - HEDIS & Quality Data

CVS Health • Work at Home, KY

84d • $54,300 - $119,340

About The Position

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. We are seeking a highly motivated and experienced individual contributor to join our team as a Mgr, Strategic Analytics - HEDIS & Quality Data. This client-facing role is critical to our mission of helping health plans improve their quality performance. The ideal candidate will be an expert in HEDIS, NCQA reporting, and STARs, with a deep understanding of health plan data and a proven track record of successful client support. This is a hands-on role that requires a blend of technical data analysis skills, strategic thinking, and exceptional interpersonal abilities. You will serve as a trusted advisor to our clients, helping them navigate the complexities of quality measurement and implement effective strategies for gap closure and performance improvement.

Requirements

• 5+ years of experience in a role focused on HEDIS, quality improvement, or healthcare data analysis, preferably within a health plan, health tech company, or consulting firm.
• Proven experience in a client-facing or consulting role, with a strong ability to manage client relationships and expectations.
• Expert-level knowledge of HEDIS technical specifications and the NCQA reporting process.
• In-depth familiarity with Medicare Advantage STAR ratings and the associated quality measures.
• Strong understanding of health plan operational data, including claims processing, clinical data exchange (e.g., EMR/EHR), and member/provider demographics.
• Proficiency in data analysis and visualization tools (e.g., SQL, Excel, Power BI, Access).
• Exceptional analytical and problem-solving skills, with a meticulous attention to detail.
• Experience with statistical analysis and data modeling is a plus.

Nice To Haves

• Excellent communication and presentation skills, with the ability to articulate complex ideas clearly and concisely.
• Strong interpersonal skills and a collaborative mindset.
• Self-motivated and able to work independently in a fast-paced environment.
• Exceptional organizational skills and the ability to manage multiple priorities effectively.

Responsibilities

• Serve as the primary point of contact for assigned clients, building strong, collaborative relationships.
• Conduct regular client meetings to review performance, present data insights, and discuss strategic initiatives.
• Provide expert guidance on HEDIS quality measures, NCQA reporting requirements, and STARs methodology.
• Translate complex data and technical concepts into clear, actionable insights for both technical and non-technical client stakeholders.
• Analyze large datasets from health plans (e.g., claims, encounters, clinical data) to identify HEDIS gaps and performance trends.
• Develop and maintain dashboards and reports to visualize quality performance metrics and key drivers.
• Perform root cause analysis on quality measure performance, identifying data integrity issues, coding discrepancies, and operational inefficiencies.
• Collaborate with internal data science and engineering teams to ensure data accuracy and the development of new analytical tools.
• Develop and recommend tailored strategies for HEDIS gap closure, including provider engagement tactics, member outreach campaigns, and care coordination initiatives.
• Monitor the effectiveness of implemented strategies and adjust as needed to optimize results.
• Stay current with changes to HEDIS specifications, NCQA standards, and CMS STARs requirements.
• Manage multiple client projects simultaneously, ensuring timely delivery and high-quality results.
• Prepare and present detailed reports and presentations for both internal and external audiences, including NCQA submission documentation and executive summaries.
• Contribute to the development of best practices and scalable processes for HEDIS data analysis and client support as well identifying new opportunities for client partnerships.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees