Manager, HEDIS, Stars, ACO Data Analytics

🔥 45 minutes ago

🏄 California, Connecticut, +12 more states – Remote

🏄 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

💵 $95k - $120k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📉 Data Analyst

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CINQCARE

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2021

🏥 Healthcare

👥 B2C

💰 Seed on 2022-01

Healthcare • B2C

CINQCARE is a community-focused healthcare organization that delivers coordinated, evidence-based medical and social care where people live — through in-home, virtual, community-based, and clinic services. It focuses on high-needs urban and rural populations, offering programs such as Grace at Home (in-home and dementia support), Care Medical Practice (local in-person clinical care), and CINQCARE for Moms (personalized perinatal and postpartum care). CINQCARE partners with local providers and payers to lower costs, simplify access, and improve outcomes by embedding care coordinators, navigators, and multidisciplinary teams in neighborhoods and homes.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

• 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.