Manage and mentor SMEs, build structured QC processes, and analyze RAF movement. Explain financial impact and trends using Excel, SQL, and Python. Define key metrics and create executive-level insights.
Key Highlights
Key Responsibilities
Technical Skills Required
Benefits & Perks
Nice to Have
Job Description
The Judge Group is hiring for a Clinical Quality and Analytics Manager for a Fully Remote Position.
Salary: $130k-$150k DOE
100% Remote
Responsibilities:
- Manage and Mentor SMEs across ICD-10 coding, HEDIS, risk assessment, STARS, and CDI.
- Build structured QC processes, root-cause analysis, and continuous accuracy improvement.
- Translate clinical corrections into coding logic updates, refine query/phrase matching, and partner with engineering to expand AI capabilities
- Analyze RAF movement, risk adjustment performance, and quality can closure
- Explain financial impact and trends using Excel, SQL, and Python
- Define key metrics, create executive-level insights, and support development of dashboards for payer clients
- Support internal teams and customers with high-level analytical thinking and structure problem solving
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Qualifications:
Experience as a coder, CDI specialist, or clinical quality expert with progression into healthcare analytics
Strong leadership experience and comfort working across clinical, technical, and business teams
Deep knowledge of ICD-10, HEDIS/NCQA, HCC/RAF, and CDI
Advanced Excel knowledge and experience with dashboards (Tableau/Power BI)
RHIA, CRC, CCS, CCDS credential required
Experience with python a plus
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