Description

Analyze HEDIS measure changes by isolating spec, value set, code, and data availability impacts, and propose system enhancements.

This role is remote.

Responsibilities

• Quantify drivers of measure changes and explain root causes to business and leadership.
• Create and influence technical specifications and data logic for HEDIS reporting.
• Research data gaps across medical, pharmacy, provider, and medical records sources.
• Assess the impact of data gaps and recommend actionable improvements.
• Conduct ad hoc vendor file research, document findings, and propose system enhancements.

Required Skills

• 5+ years of experience as a Business Analyst or similar role.
• Deep understanding of HEDIS data structures and measure logic.
• Hands-on SQL writing experience for complex data analysis.
• Proficiency with ETL tools including Informatica (IICS) and Wherescape.
• Experience working with Databricks.
• Ability to separate rate differences from structural data changes.
• Bachelor’s degree in any field.

Key Skills

Education

Any Gradute