HEDIS Data Quality Integrity Analyst

This is a fully remote position, open to applicants in Connecticut, +3 more states.

📋 Description

• Act as the technical leader for the design and execution of HEDIS data quality analytics.

• Develop and implement a systematic approach to ensure the accuracy of HEDIS member health-status data.

• Oversee quality performance analytics, development, and reporting initiatives.

• Gather business requirements in accordance with State, CMS, and NCQA specifications.

• Convert business requirements into analytical designs and establish data and analytics specifications.

• Handle and analyze substantial healthcare datasets from diverse data sources.

• Interpret results to pinpoint opportunities and solutions that enhance clinical quality, cost efficiency, and healthcare affordability.

• Direct projects aimed at improving HEDIS, Stars, accreditation, and State performance metrics.

• Manage vendor relationships with those supporting quality performance initiatives.

• Develop quality assurance criteria and processes to guarantee that regulatory reporting data is complete and accurate.

• Serve as the analytic liaison for complex clinical analytics projects that involve multiple data resources and teams.

• Create integrated analytical datasets and summarize findings related to business opportunities and inquiries.

• Offer insights and guidance on analytic findings, including root causes and contributing factors.

• Disseminate analytics designs, results, and interpretations across analytical and business units.

• Document methodologies, specifications, findings, SAS coding comments, and analytic plans/timelines.

• Present analytical findings to internal leadership teams.

• Deliver technical training to junior analysts in areas such as analytics design, data, programming, quality assurance, statistics, and documentation.

⛳️ Requirements

• High School Diploma/GED is mandatory.

• A Bachelor's degree in Math, Statistics, Data Science, or Public Health is preferred, or relevant experience may be considered in lieu of a degree.

• At least 5 years of experience in data analytics, HEDIS, SAS, or a related field is required.

• Minimum of 5 years of experience analyzing healthcare data, HEDIS data, or relational healthcare databases, with substantial experience in medical, pharmacy, and behavioral data analysis.

• In-depth knowledge of the US healthcare industry, health plan operations, claims data, clinical data, and coding practices.

• Familiarity and practical experience with visualization and BI tools (e.g., Tableau) is preferred.

• Strong preference for candidates with SAS, SQL, and Python experience.

• Proficiency in MS Excel for data analysis and reporting purposes.

• Excellent organizational skills and meticulous attention to detail.

• Ability to thrive in a fast-paced, team-oriented environment while managing competing priorities.

• Highly motivated and capable of working independently.

🏝️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision).

• Retirement plans.

• Generous paid time off (PTO).

• Incentive plans.

• Wellness programs.

• Paid volunteer time off.

• Tuition reimbursement.