Quality & Regulatory Data Analyst - St. Luke's Health Plan

St. Luke's Health System•Boise, ID

6d•Remote

About The Position

The Quality & Regulatory Data Analyst focuses on HEDIS and Stars metrics, partnering across business segments within St. Luke’s Health Plan to support business processes and deliver health insurance data analysis and insights aligned with organizational strategies. The role supports healthcare quality improvement, regulatory performance, operational excellence, and improved member outcomes. The analyst transforms medical, pharmacy, eligibility, quality, and operational data into actionable insights; develops expertise in healthcare quality and regulatory programs; identifies care gaps and measures intervention effectiveness; and collaborates with clinical, operational, and business leaders to develop recommendations. The role also supports data validation, reconciliation, governance, data quality, and analytics best practices, and uses SQL, Excel, and other analytical tools to contribute to reporting and strategic projects. The position is fully remote, but candidates must live in Idaho, Oregon, Arizona, or Utah.

Requirements

Bachelor’s degree or equivalent experience in lieu of a degree.
Three years of relevant experience.
Must live in Idaho, Oregon, Arizona, or Utah to be considered.

Nice To Haves

Experience with healthcare analytics in a payer and/or provider environment.
Knowledge of Medicare Advantage Star Ratings, CMS Quality Programs, HEDIS, CAHPS, HOS, Part D, or related quality measures.
Strong analytical, data validation, and problem-solving skills.
Ability to communicate insights effectively and collaborate across technical and business teams.
Advanced SQL and Excel skills; Python experience is a plus.
Curiosity, initiative, and a passion for using data to improve healthcare outcomes.

Responsibilities

Analyze medical, pharmacy, eligibility, quality, and operational data to identify trends, solve problems, and support business decisions.
Develop subject matter expertise in Medicare Advantage Star Ratings, HEDIS, CAHPS, HOS, Part D, risk adjustment, and other healthcare quality and regulatory programs.
Identify care gaps, measure intervention effectiveness, and contribute to quality improvement and better member outcomes.
Partner with clinical, operational, and business leaders to translate complex questions into analysis and recommendations.
Validate and reconcile data in collaboration with internal teams and external partners.
Contribute to data governance, data quality, analytics best practices, reporting, and insights.
Use SQL, Excel, and other analytical tools to identify opportunities and communicate findings.
Participate in strategic projects influencing healthcare quality, operational performance, and member experience.