Manager, HEDIS, Stars, ACO Data Analytics

🕒 Julho 27

🏄 California, Connecticut, +12 estados a mais – Remoto

🏄 California – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🦀 Maryland – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote ⚔️ Virginia – Remote ☕ Washington – Remote

💵 $95.000 - $120.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

📉 Analista de Dados

👻 Score fantasma 26%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

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CINQCARE

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 2021

🏥 Saúde

👥 B2C

💰 Seed em 2022-01

Healthcare • B2C

A CINQCARE é uma organização de saúde focada na comunidade que oferece cuidados médicos e sociais coordenados e baseados em evidências onde as pessoas vivem — através de serviços domiciliares, virtuais, baseados na comunidade e em clínicas. A CINQCARE concentra-se em populações urbanas e rurais de alta necessidade, oferecendo programas como o Grace at Home (apoio domiciliar e para demência), Care Medical Practice (assistência clínica presencial local) e CINQCARE for Moms (cuidados personalizados durante o pré e o pós-parto). A CINQCARE faz parcerias com provedores e pagadores locais para reduzir custos, simplificar o acesso e melhorar os resultados, incorporando coordenadores de cuidados, navegadores e equipes multidisciplinares nos bairros e lares.

Descrição

• The Manager of HEDIS, Stars & ACO Data Analytics leads all aspects of HEDIS, Medicare Stars, and ACO quality measurement and reporting across product lines. • This role ensures technical excellence, regulatory compliance, audit readiness, and timely submissions in accordance with the National Committee for Quality Assurance (NCQA), Centers for Medicare & Medicaid Services (CMS), and the Executive Office of Health and Human Services (EOHHS). • The Manager drives quality performance improvement, optimizes pay-for-performance outcomes (e.g., Medicare Stars and Quality Withhold), oversees electronic clinical data integration, and works in a matrix environment with a multidisciplinary analytics team. • Lead the full HEDIS lifecycle: planning, data collection, validation, rate calculation, submission, and audit. • Conduct performance analysis and root cause reviews to improve quality scores and financial incentives. • Present results and performance insights to leadership and quality committees. • Partner with internal teams and external stakeholders to enhance data systems and quality outcomes. • Manage HEDIS software vendors and work with NCQA-certified auditors.

🎯 Requisitos

• Education: Bachelor’s degree in health, informatics, data science, or related field required; Master’s degree (MBA, MPH, MS, or related) preferred. • Experience with Microsoft suite of tools (Excel, Word, PowerPoint, OneNote, Access etc.), PowerBI, and Tableau required; SAS, SQL, and other statistical tools preferred. • 5+ years in healthcare analytics; 5–10 years of HEDIS leadership experience. • Experience leading HEDIS audits. • Strong knowledge of HEDIS/QRS specifications, Medicare Stars measures, and healthcare data systems. • Proven team leadership and project management experience. • Strong analytical and communication skills. • Vendor management and process implementation experience.

🏖️ Benefícios

• Competitive Compensation: We offer competitive salaries to attract and retain the best talent. • 401(k) with Employer Match: Plan for your future with our 401(k) plan and a generous 4% employer match. • Comprehensive Medical Plan: We proudly offer a comprehensive medical option with an employer contribution. • Dental & Vision Coverage: Maintain your oral and eye health with our employer-paid dental and vision plans via MetLife. • Employer-Paid Insurance: Life, Short-Term Disability (STD), and Long-Term Disability (LTD) insurance are provided at no cost to you. • Generous Paid Time Off: Enjoy ample time off for rest and rejuvenation with generous PTO, holidays, and wellness time. • Continuing Medical Education (CME) Allowance for APPs: Stay at the forefront of your field with our CME allowance. • Commuter Benefits: Save on your commute with our commuter benefits program. • Mileage Reimbursement: Get reimbursed for work-related travel expenses.