DATE: May 21, 2026
POSITION: Health Data Analyst – Quality Management
DEPARTMENT: Clinical Services
RATE: $25.00 per hour, with potential for additional compensation based on qualifications.
This position is responsible for transforming complex health plan data into meaningful insights that support service delivery, cost management, quality improvement, and access to care. Using medical, dental, and pharmacy claims, hospital utilization data, revenue and enrollment data, the Health Data Analyst partners with internal teams to meet a wide range of analytical and reporting needs. The role also supports quality management initiatives, including Healthcare Effectiveness Data Information Set (HEDIS) and enterprise registry tools, reporting, ensuring accurate and timely quality measure evaluation to guide performance improvement efforts.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Follows established Upper Peninsula Health Plan (UPHP) policies and procedures, objectives, safety standards, and sensitivity to confidential information.
2. Performs all assigned tasks in accordance with UPHP plans, policies and procedures, National Committee for Quality Assurance (NCQA) standards, and all regulatory standards and contractual requirements.
3. Collaborates with internal health plan staff to define data analysis projects, identify appropriate data sources, and develop meaningful and actionable output. Serves as a super user for quality data and population health web-based applications, providing ongoing support and training for internal and external end-users.
4. Collects, cleans, and validates healthcare data from multiple sources, including dashboards, scripts, and enterprise registry tools; organizes and analyzes data to identify patterns and trends; develops and maintains data preparation and validation routines; and reviews reports to ensure accuracy and reliability.
5. Develops and maintains quality payment scorecard reporting processes using SQL and VBA, streamlines monthly code calculations, enhances data accuracy, optimizes value-based payment data pulls, and creates reliable reports and member lists for clinic review.
6. Develops and maintains provider value-based payment scorecards by ensuring accurate, timely reporting and data validation, and prepares charts, graphs, and tables to meet clinical services reporting needs.
7. Develop interactive dashboards and analytical reports using tools such as Tableau and Microsoft Excel.
8. Assures resolution of identified problems in clinical data in conjunction with the medical director, chief quality officer, clinical services managers, HEDIS lead, clinical coordinators, and the Information Systems (IS) department.
9. Working knowledge of SQL to write, link, and optimize queries for accessing and analyzing complex healthcare data across multiple tables and sources.
10. Manages quality projects within the Clinical Services department, tracking multiple initiatives and meeting tight deadlines.
11. Designs, develops, and maintains Microsoft Access databases to support healthcare data storage and analysis, and keeps up-to-date documentation of all processes and work performed.
12. Demonstrates general knowledge of NCQA standards and HEDIS measures as they relate to clinical reporting.
13. Attends and participates in organizational, departmental, and clinical team meetings, as well as with external entities when required.
14. Maintains confidentiality of client data.
15. Performs other related duties as assigned or requested.
POSITION QUALIFICATIONS:
Education:
Minimum:
Bachelor’s degree in appropriate science or related discipline such as health information technology, health information management, computer information systems or related field
Preferred:
Bachelor’s degree in management information systems, computer science, health informatics, or data analytics.
Experience:
Minimum:
One (1) to three (3) years of coursework related to healthcare data analysis or computer science
Preferred:
Three (3) to five (5) years working in a healthcare setting with progressive experience in data reporting and project management
Required Skills:
Keyboarding proficiency and advanced knowledge of Microsoft Office (Word, Excel, Access, and PowerPoint) including proficiency in database management
Understanding of SQL
Advanced proficiency with Tableau Desktop and Server
Excellent human relation and oral/written communication
Excellent project management and organizational abilities
Ability to work independently and manage multiple tasks effectively
Ability to be flexible and adaptable to changing priorities
Desired Skills:
Knowledge of terminology and concepts used in the healthcare and health insurance industry
Knowledge of accounting and health-care software systems/applications
Knowledge of claims and coding and billing methodologies
Knowledge of clinical HEDIS, NCQA, and CMS regulations
The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.
Physical Requirements:
[This job requires the ability to perform the essential functions contained in the description. These include, but are not limited to, the following requirements. Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements]:
Ability to enter and access information from a computer
Occasionally lifts supplies/equipment
Prolonged periods of sitting
Manual dexterity
Working Conditions:
Works in office conditions, but occasional travel may be required
Subject to many interruptions
Exposure to situations requiring exceptional interpersonal skills or high productivity
Occasionally subjected to irregular hours
