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Director Hedis Analyst Jobs (NOW HIRING)

Aegis Medical Group

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HEDIS Coordinator

Clermont, FL · On-site

$16.50 - $20/hr

... without direct patient contact. Responsibilities * Collect and analyze healthcare quality data from various sources * Monitor compliance with HEDIS measures and regulatory requirements * Audit ...

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Aegis Medical Group

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HEDIS Coordinator

Holiday, FL · On-site

$16.50 - $20/hr

... without direct patient contact. Responsibilities * Collect and analyze healthcare quality data from various sources * Monitor compliance with HEDIS measures and regulatory requirements * Audit ...

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Epitec

Quality Audit Specialist

Chicago, IL · On-site

$40 - $44/hr

Contract * Job #104624 Clinical Quality Data Analyst (HEDIS) Overview We're hiring a Clinical Quality Data Analyst to support HEDIS reporting, medical record validation, and healthcare quality ...

SA Technologies Inc.

Sr.Data Analyst

Pasadena, CA

$93K - $118K/yr

Company Description All SA Technologies requirements are Direct Client Requirements from IT Hiring ... Broad familiarity with Hedis. Must be an independent self-starter. Desired Skills: Minimum 4 years ...

TEEMA Group

Medical Director - Pediatrics

Phoenix, AZ · Remote

$140 - $145/hr

Medical Director - PediatricsRole Summary Are you an accomplished physician executive with a ... Track and analyze key performance indicators (KPIs), utilization management data, and HEDIS/quality ...

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Director Hedis Analyst information

What are Director HEDIS Analysts?

Director HEDIS Analysts are senior professionals responsible for overseeing the Healthcare Effectiveness Data and Information Set (HEDIS) programs within healthcare organizations. They manage teams that collect, analyze, and report quality performance data to ensure compliance with regulatory standards and improve patient care. Their role often includes developing strategies to enhance HEDIS measure outcomes, collaborating with clinical and IT departments, and ensuring accurate data submission to accrediting bodies. Directors also stay updated on changing HEDIS requirements and work to implement best practices throughout their organization.

What are the key skills and qualifications needed to thrive as a Director HEDIS Analyst, and why are they important?

To thrive as a Director HEDIS Analyst, you need expertise in healthcare data analysis, quality measurement, and a strong understanding of HEDIS metrics, often supported by a degree in health informatics, public health, or a related field. Experience with analytic tools such as SAS, SQL, and healthcare data platforms, along with knowledge of NCQA regulations and HEDIS reporting systems, is crucial. Outstanding leadership, problem-solving, and communication skills help drive quality initiatives and manage cross-functional teams. These skills are essential to ensure accurate reporting, regulatory compliance, and continuous improvement of healthcare quality outcomes.

What is the difference between Director Hedis Analyst vs Hedis Analyst?

AspectDirector Hedis AnalystHedis Analyst
Required CredentialsBachelor's degree, possibly advanced certifications in healthcare or analyticsBachelor's degree in healthcare, statistics, or related field
Work EnvironmentLeadership role overseeing teams, strategic planningData analysis, reporting, and compliance tasks
Employer & Industry UsageHealthcare organizations, insurance companiesHealthcare providers, insurance companies, analytics firms
Common Search & ComparisonHigher-level responsibilities, management focusData-focused, operational role

The main difference between a Director Hedis Analyst and a Hedis Analyst lies in their level of responsibility. The Director Hedis Analyst typically oversees teams and strategic initiatives, requiring leadership skills and possibly advanced certifications. In contrast, the Hedis Analyst focuses on data analysis and compliance tasks. Both roles are vital in healthcare analytics but differ in scope and seniority.

How does a Director HEDIS Analyst typically collaborate with clinical and IT teams to improve data quality and reporting?

A Director HEDIS Analyst often serves as a bridge between clinical, IT, and quality improvement teams to ensure accurate and timely data collection and reporting for HEDIS measures. They coordinate with IT to optimize data extraction from electronic health records, and work closely with clinicians to clarify documentation requirements and address data gaps. Regular meetings, cross-functional training sessions, and collaborative problem-solving are common, fostering a team environment focused on continuous improvement in data quality and compliance.
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Infographic showing various Director Hedis Analyst job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 1% Internship, 86% Full Time, 6% Part Time, 1% Temporary, and 5% Contract. Highlights an 82% Physical, 5% Hybrid, and 13% Remote job distribution.
Director HEDIS & Quality Improvement Analytics

Director HEDIS & Quality Improvement Analytics

Medical Mutual of Ohio

Cleveland, OH • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

Medical Mutual of Ohio rating

8.6

Company rating: 8.6 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

82nd of 281 rated insurance

Job description

Medical Mutual employees must submit their applications through MySource.
This is a hybrid-remote role based out of the Brooklyn, OH office, with the Director HEDIS & Quality Improvement Analytics expected to work onsite on four designated in-office days each week.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
Director HEDIS & Quality Improvement Analytics
Job Summary:
Directs operations and staff engaged in Healthcare Effectiveness Data and Information Set (HEDIS) and clinical quality improvement analytics and supplemental data functions. Ensures adherence to reporting requirements of the National Committee on Quality Assurance (NCQA), and regulatory agencies. Leverages and delivers clinical quality improvement management data and reporting that support the health plan's strategies, goals, and initiatives for all lines of business (Commercial, Marketplace, Medicare Advantage, and Stars).
Responsibilities:
  • Directs the HEDIS annual submission process. Develops and manages work plans; establishes and ensures timelines are adhered to, assigns responsibilities, and monitors and reports progress to internal stakeholders.
  • Directs and coordinates the preparation of the HEDIS roadmap including all data sources and exchanges with vendors and providers.
  • Leads strategic planning based on reporting and year over year comparisons for continual process improvement of Stars and HEDIS scores and overall accreditation for all lines of business.
  • Measures trends, discusses reasoning behind trend, and calls out any significant changes.
  • Leads the process for defining operational improvements within the health plan based on HEDIS performance following the annual HEDIS audit.
  • Builds relationships with internal and external customers. Communicates progress and results through presentations to key stakeholders, including senior leadership.
  • Presents at Joint Operating Committee (JOC) meetings with Physicians and Administrative Health System leadership.
  • Leads strategic projects related to the use of supplemental data (internal, external and in the vendor space) to enhance performance for all lines of business for HEDIS improvement results and overall HealthPlan scores.
  • Enhances reporting for Member Assistance Program (MAP) members and other clinical areas to identify assigned staff to cases for tracking and care gap closure opportunities
  • Collaborates with internal stakeholders to ensure data warehouse architecture development and utilization.
  • Directs the supplemental data team responsible for Extraction, Transformation and Loading (ETL) including the design, building, testing, and maintaining of ETL jobs.
  • Oversees the translation of functional ETL requirements into technical design elements to be utilized by internal teams for managing and maintaining supplemental data.
  • Directs external client relationships with regards to supplemental data including providing technical specifications to clients (SFTP set-up, file layout, etc.), establishing a cadence for data submission, monitoring the processing of data files, and working with the client to improve the impact of supplemental data on HEDIS measures.
  • Develops and maintains Value-Based Consulting (VBC) reporting to support the VBC contracting outcomes and team
  • Participates in contracting calls with Provider groups to supply details on supplemental data files and care gap measures scores. Collaborates with provider groups key contacts to enhance the data files.
  • Manages staff developing quality measurement analytics and reporting for internal use and regulatory submissions including staffing, training and development and performance management. Ensures deliverables are reliable, valid, and actionable.
  • Performs other duties as assigned.

Qualifications:
Education and Experience:
  • Bachelor's Degree in Business or Health Care Administration, Public Health, or a related field.
  • Master's degree preferred.
  • 8 years of experience in health plan or health care analytics which includes HEDIS and clinical quality improvement, 5 years of which is in a leadership capacity.

Professional Certification(s):
Technical Skills and Knowledge:
  • Comprehensive knowledge of the end-to-end HEDIS cycle (e.g., abstraction, data submission, audit, etc.) and the ability to apply advanced concepts to Company operations.
  • Expert knowledge of and proficiency with NCQA-certified HEDIS software.
  • Extensive knowledge of NCQA and CMS measurement, reporting and regulatory requirements.
  • Intermediate to advanced knowledge of and proficiency with analytic programming languages and data visualization tools, including SAS, SQL, Cognos, Tableau, and Microsoft Visual Studio.
  • Familiarity with multiple data source formats, including delimited flat files, web services, and SharePoint list XML.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
  • We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
  • Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
  • On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
  • Discounts at many places in and around town, just for being a Medical Mutual team member.
  • The opportunity to earn cash rewards for shopping with our customers.
  • Business casual attire, including jeans.

Excellent Benefits and Compensation:
  • Employee bonus program.
  • 401(k) with company match up to 4% and an additional company contribution.
  • Health Savings Account with a company matching contribution.
  • Excellent medical, dental, vision, life and disability insurance - insurance is what we do best, and we make affordable coverage for our team a priority.
  • Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
  • Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
  • After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:
  • Career development programs and classes.
  • Mentoring and coaching to help you advance in your career.
  • Tuition reimbursement up to $5,250 per year, the IRS maximum.
  • Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
#LI-CS1 #LI-HYBRID
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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