HEDIS Data Analyst

Remote • Posted 4 hours ago • Updated 4 hours ago
Contract W2
6 Months
No Travel Required
Remote
Depends on Experience
Fitment

Dice Job Match Score™

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Job Details

Skills

  • Data Analyst
  • SQL
  • HEDIS

Summary

Role: HEDIS Data Analyst 
Location: Newark, NJ or nearby (remote, 2–4 days/month onsite) 
6 months+

Key Responsibilities:
·     HEDIS Analytics → Develop/validate HEDIS measures per NCQA specs, analyze claims/eligibility/EHR/pharmacy/lab data, support annual submissions, audits, and dashboards.
·     Data Engineering → Build/optimize SQL queries, ETL pipelines, and data transformations; improve data quality; document lineage and mappings.
·     Chart Review → Manage provider lists, validate chart abstraction, support outreach for care gaps.
·     Collaboration → Work with Quality, Clinical, Provider Relations, and Compliance teams; provide guidance on anomalies; present insights to leadership.
·     Audit & Compliance → Assist with NCQA audit prep, ensure regulatory adherence, maintain audit trails and reporting artifacts.

Technical Skills:
·     Advanced SQL (required)
·     Experience with healthcare payer datasets (claims, eligibility, provider, EMR, pharmacy, lab)
·     Knowledge of coding standards (ICD‑10, CPT, HCPCS, LOINC, NDC)

Domain Knowledge:
·     Deep understanding of NCQA HEDIS specs
·     Experience with hybrid & administrative measures
·     Familiarity with audit processes, care gap workflows, and CMS Star Ratings

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 10448332
  • Position Id: UC070826
  • Posted 4 hours ago
Contact the job poster
RK

Raj Kasipally

Recruiter @ Delviom LLC
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