Senior Analyst, Health Care Quality Management

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

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.

• 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 Git Hub 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.

• 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,…