Clinical Quality Data Analyst - Remote

Overview

The Clinical Quality Data Analyst will manage business processes related to the Clinical Quality Program and HEDIS, ensuring compliance with state and federal regulations while supporting quality improvement initiatives.

In Short

• Manage core business processes related to HEDIS and quality improvement.
• Ensure successful HEDIS submissions and compliance with regulations.
• Serve as a subject matter expert for HEDIS and quality programs.
• Analyze health care quality related data and recommend improvements.
• Collaborate with teams to implement initiatives.
• Develop training materials and educate contract nurses.
• Conduct inter-rater reliability testing.
• Provide quantitative and qualitative analysis of HEDIS results.
• Support Wellmark’s quality improvement work plans.
• Comply with internal policies and regulatory standards.

Requirements

• Registered nurse with a bachelor’s degree or relevant experience.
• 2+ years of experience in analyzing health care quality data.
• Strong attention to detail and analytical skills.
• Knowledge of regulatory standards and accreditation.
• Excellent written and verbal communication skills.
• Strong consultation and relationship management skills.
• Proficiency in Microsoft Office applications.
• Ability to travel 5-10% as needed.

Benefits

• Flexible work environment with remote options.
• Comprehensive benefits package.
• Opportunities for professional development.
• Supportive workplace culture focused on member well-being.
• Engagement in quality improvement initiatives.