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Lead Clinical & Population Health Analyst - HEDIS

Highmark Health

Company :

Highmark Health

Job Description : 


This job creates data-driven insights which identify actionable opportunities and/or create analytics and reporting solutions aligned to the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes from and quality of care received, and optimal member/patient and provider experiences with care delivery. The incumbent serves as a consultative subject matter and technical expert for internal and external customers, leveraging advanced analytical expertise and experience to aggregate, analyze and understand patterns in varied and complex data; and articulates analytic findings, business implications, and recommendations to realize identified opportunities.


  • Leads the design, development, execution, dissemination and interpretation of clinical and population health analyses, metrics and reports using clinical, member, financial and administrative data to identify, develop and/or monitor actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to successful completion.
  • Establishes strong, collaborative and effective relationships and communication with internal and external clinical, administrative, operational, financial and technical stakeholders to ensure analytics are actionable and aligned with organizational strategic priorities, needs, plans and resources.
  • Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought leadership and subject matter expertise, and by anticipating and actively proposing, designing and executing analyses.
  • Provides consultative, technical, subject matter and business expertise mentorship to colleagues across the enterprise.
  • Other duties as assigned or requested.



  • Master's Degree in Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy or related field


  • Bachelor’s Degree in Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology, Pharmacy OR related field with 2 years of relevant work experience in lieu of a Master’s Degree OR 8 years of relevant work experience


  • Doctorate in Medicine, Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology, Pharmacy or related field



  • 7 years of leading the design, execution and dissemination of clinical and population health reporting, analyses and studies of progressive scope and complexity
  • 7 years with coding languages, analytical software, systems, tools and processes using claims, clinical, enrollment and provider data
  • 5 years of project leadership in a complex, matrixed environment (payer and/or provider preferred)
  • 5 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders


  • None



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  • Demonstrated record of data-driven discovery, intense intellectual curiosity, and a passion for working with data to answer important questions about clinical care and population health that drive the Quadruple Aim
  • Strong working knowledge of coding languages, relational databases, quantitative and qualitative analytic methodologies, advanced analytics and statistics
  • Excellent communication and facilitation skills with project team members, stakeholders, executives, and external customer, exceptional written and oral presentation skills, proven ability to communicate interpersonallly and technically with technical and non-technical, and internal and externbal audiences, and the ability to lead through influence
  • Healthcare industry expertise and experience, knowledge about the shifting healthcare environment including trends concerning health insurance, healthcare delivery, provider relationships and regulatory issues
  • Sophisticated knowledge of how organizations work and how to get things done through formal and informal channels
  • Exhibition of perseverance through energy, drive and demonstrated success when resistance or setbacks are encountered
  • In-depth understanding of and experience with both clinical and business processes, and the ability to identify opportunities for improvement and develop solutions
  • Demonstrated ability to informally lead matrixed teams of technical, clinical, administrative, financial and operational staff to achieve shared organizational objectives and strategic goals

Language (Other than English):


Travel Requirement:

0% - 25%


Position Type


Teaches / trains others regularly


Travel regularly from the office to various work sites or from site-to-site


Works primarily out-of-the office selling products/services (sales employees)


Physical work site required


Lifting: up to 10 pounds


Lifting: 10 to 25 pounds


Lifting: 25 to 50 pounds


Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.


Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( )

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