Measure Optimization Lead - Care Coordination
Core
Lead HEDIS Care Coordination measure optimization strategy to improve CMS Stars quality ratings for Medicare Advantage and Prescription Drug Plans.
Role type
Senior IC data analyst / business intelligence lead (healthcare quality)
Builds
Strategic recommendations and implementation plans for Care Coordination measures
Domain
Healthcare / Insurance / Quality Measurement (HEDIS/CMS Stars)
Deliverable
dashboards & analysis
Required skills
HEDIS measure expertise, CMS Star Ratings knowledge, data analysis, business intelligence, cross-functional collaboration, strategic leadership, root cause analysis, executive communication
Preferred skills
Care Coordination specific measures (Follow-Up After ED, Transitions of Care, Readmissions), payer claims data analysis, clinical data review, healthcare vendor management
Technologies
Power BI, Tableau, Qlik, SQL
Responsibilities
Lead HEDIS Care Coordination measure optimization strategy; Evaluate business and operational factors affecting measure outcomes; Translate measure requirements and insights into implementation plans; Prepare high-quality materials for senior leadership; Collaborate with clinical, operations, and analytics teams to enhance measure performance; Define business reporting requirements and success measures
Seniority
Senior, hands-on IC with strategic leadership
