HEDIS Data Analyst

Job Summary

To support healthcare quality improvement initiatives, the full-time HEDIS Data Analyst will develop and validate HEDIS measures, optimize data processes, and collaborate with various teams, working remotely with occasional onsite meetings in Newark, NJ.

Key responsibilities:

• Develop and validate HEDIS measures according to NCQA specifications and analyze various healthcare data sources
• Build and optimize SQL queries and ETL pipelines to improve data quality and document data lineage
• Manage chart reviews and collaborate with Quality, Clinical, and Compliance teams to provide insights and support audits

Required qualifications:

• Advanced SQL proficiency
• Experience with healthcare payer datasets, including claims and eligibility data
• Deep understanding of NCQA HEDIS specifications
• Familiarity with coding standards such as ICD 10, CPT, and LOINC
• Knowledge of audit processes and care gap workflows