[Hiring] Senior Analyst, Health Care Quality Management @CVS Health

Role Description

The Senior Analyst, Health Care Quality Management transforms healthcare data into reliable, actionable insights that improve population health, quality performance, and member outcomes. This role supports the Quality Management department through analysis of healthcare claims, enrollment, member, provider, pharmacy, clinical, HEDIS, Stars, EPSDT, and quality performance improvement project data. Working with appropriate guidance and increasing independence, the analyst manages assigned analytical projects; develops automation and reporting solutions using SQL, Python, Power BI, and AI-assisted development tools; and partners with clinical, operational, technical, and leadership stakeholders to identify root causes, evaluate interventions, and support improvement strategies.

Key Responsibilities

• Manage assigned healthcare analytics projects from requirements gathering through analysis, validation, interpretation, and presentation, with guidance on complex assignments.
• Develop, test, document, and support Python-based automation and analytical workflows that improve reporting efficiency and consistency.
• Write and troubleshoot SQL queries for healthcare data extraction, analysis, validation, reporting, and issue investigation.
• Build, maintain, and enhance Power BI dashboards, scorecards, and reports that communicate quality performance, testing results, defects, trends, interventions, and key performance indicators.
• Integrate, validate, and analyze data from multiple sources, including medical and pharmacy claims, member enrollment, provider, clinical, laboratory, HEDIS, Stars, EPSDT, and population health datasets.
• Conduct quantitative and root cause analyses to identify performance drivers, data issues, care gaps, process breakdowns, and opportunities for quality improvement.
• Evaluate population health interventions, member outreach, provider engagement, Quality Performance Improvement Projects, EPSDT initiatives, and other Quality Management programs.
• Ensure the accuracy, completeness, quality, and integrity of analytical outputs through structured validation, reconciliation, documentation, and review.
• Use AI-assisted development tools, including GitHub Copilot or comparable solutions, to accelerate development, improve code quality and documentation, and increase productivity while following applicable privacy, security, and governance requirements.
• Collaborate with Quality Management, clinical, provider, operations, informatics, engineering, and reporting teams to gather requirements and translate business needs into practical analytical solutions.
• Communicate findings, risks, limitations, and recommendations through clear written deliverables, data visualizations, and presentations for technical and nontechnical audiences.
• Complete recurring and ad hoc reporting deliverables accurately and on time; support data-quality investigations, audits, and special projects as assigned.
• Contribute to continuous improvement of team methods, documentation, analytical practices, and quality controls.

Qualifications

• 1-2 years of experience in healthcare analytics, quality measurement, data analysis, business intelligence, reporting, or a related field; relevant internship or project experience may be considered.
• Knowledge of HEDIS, Medicaid Stars, quality measurement, care-gap identification, or healthcare performance reporting.
• Experience building or supporting Power BI reports or dashboards and strong Microsoft Excel skills.
• Ability to perform root cause analysis, manage priorities, and deliver accurate results with increasing independence.
• Effective written and verbal communication skills, attention to detail, and ability to safeguard confidential healthcare data.

Preferred Qualifications

• Experience using AI-assisted development tools, such as GitHub Copilot, for coding, analysis, automation, or documentation.
• Experience or knowledge in population health analytics, Quality Performance Improvement Projects, EPSDT, Medicaid, managed care, HEDIS, or Stars.
• Knowledge of relational databases, data modeling, version control, data-quality controls, or automated validation.
• Working proficiency in SQL and some experience using Python for data analysis, automation, or scripting.

Education

• Associates degree, vocational training, or Certification in health informatics, data science, analytics, statistics, computer science, public health, healthcare administration, business, or a related field; or an equivalent combination of education and relevant experience.
• Relevant healthcare analytics, data, quality, or technical certifications are a plus.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $46,988.00 - $122,400.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Company Description

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.