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HEDIS Analyst

Company: Oscar Health Insurance
Location: New York
Posted on: June 12, 2021

Job Description:

Hi, we're Oscar. We're hiring an Analyst, HEDIS to join our Value Capture team in our New York office.

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

About the role:

In this role, you will assist with key operations for a core Oscar insurance function called Value Capture. Under the Value Capture umbrella exists two groups known as Risk Adjustment and Quality, which are the only operations that can affect Oscar's bottom line after we've set premium rates.

Your role will be focused on supporting HEDIS and STAR's initiatives with both our vendors and internal stakeholders. You will serve as the primary point of contact for analytics and reporting within the operations team for HEDIS. You will partner with the Revenue Operations and NCQA team to ensure execution and understanding performance in all measures.

You will work closely with other departments to guarantee regulatory compliance and improve ACA/MA STARS. In this role you'll build and refine workflows while also tracking progress to meet critical CMS deadlines. You'll help manage data for health systems, vendor partners, and internal stakeholders. You'll identify inefficiencies and recommend tactical program improvements. This position requires you to be data and operationally savvy.

You will report into the Associate Director, Value Capture Strategy and Analytics.


  • Collect and analyze data to implement and monitor quality improvement initiatives that will achieve Star Program outcomes for all lines of business
  • Design and operationalize member engagement campaigns and monitor their success
  • Maintain up to date standards for CMS and State guidelines and NCQA specifications
  • Establish relationships with internal and external stakeholders (Vendors, Population Health, Risk Adjustment, Concierge) to foster an increased understanding of the HEDIS process
  • Develop strategies and collaborate with executive leadership using advanced quantitative and qualitative data analytics to drive short and long term quality performance improvement for members and providers engagement
  • Optimize member health by increasing penetration of evidence-based preventative and chronic care measures by identifying care gaps and barriers
  • Coordinate information between departments to improve quality of care to our members


  • Bachelors in Business, Data Analytics, Health Administration or related field
  • Deep understanding of HEDIS specification and STAR's measures
  • 2+ years experience with SQL
  • Experience managing vendor relationships

Bonus points:

  • Experience in a tech/startup environment

Life at Oscar:

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ( to make the need for an accommodation known.

Pay Transparency Policy:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

Keywords: Oscar Health Insurance, New York , HEDIS Analyst, Other , New York, New York

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