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Please find the Job Description (JD) below.
Role : Senior HEDIS Data Engineer
Location : Remote
Hands on experience in customer data analysis involving UNIX file-handling commands and scripting are limited
We are looking for a Senior Data Engineer with Hands on experience in customer data analysis involving UNIX file-handling commands and scripting are limited
You will design, build, and maintain the pipelines and
platforms that power HEDIS measure calculation, quality reporting, and regulatory submissions
across the company. This role is for someone who understands the technical and clinical
nuances of HEDIS data - supplemental data, hybrid measures, NCQA specifications - and
can translate that into reliable, well-documented data pipelines.
What You'll Do
Design, build, and maintain scalable batch and streaming data pipelines supporting
HEDIS measure calculation and reporting
Ingest and transform claims, encounter, lab, pharmacy, and supplemental data feeds
used in HEDIS measure logic
Implement and maintain HEDIS measure specifications (NCQA Volume 2) in code,
ensuring accurate translation of clinical logic into data transformations
Support annual HEDIS reporting cycles, including hybrid measure data collection, rate
calculation, and submission-ready extracts
Build automated testing and validation to confirm HEDIS measure outputs match
specification and prior-year trends
Partner with quality/clinical teams, compliance, and analytics to understand measure
requirements and NCQA/CMS updates each year
Investigate and resolve discrepancies in HEDIS rates, source data gaps, and measure
logic issues
Maintain clear documentation of data lineage, transformation logic, and measure
mappings for audit and NCQA review purposes
Continuously improve pipeline architecture for scalability, performance, and data
integrity across HEDIS reporting workflows
What We're Looking For
5+ years of experience in data engineering or a closely related field, including direct
HEDIS experience
Hands-on experience with HEDIS measure specifications (NCQA Volume 2) and HEDIS
reporting cycles
Familiarity with healthcare data types relevant to HEDIS: claims, encounters, eligibility,
pharmacy, lab, and supplemental data
Strong SQL skills and hands-on experience with at least one major data warehouse
(Snowflake, BigQuery, Redshift, or similar)
Proficiency in Python or Scala/Java for building production data pipelines
Experience with modern orchestration tools (Airflow, Dagster, Prefect, or similar)
Solid understanding of data modeling, dimensional design, and ETL/ELT best practices
in a healthcare context
Experience working with or alongside HEDIS/quality measure engines (e.g., Inovalon,
Cotiviti, MedInsight, or custom rules engines) is a plus
HEDIS Experience
We are hiring specifically for someone with hands-on HEDIS (Healthcare Effectiveness Data and
Information Set) experience. In this role, you will be expected to:
Have directly built, maintained, or supported pipelines feeding HEDIS measure
calculation or rate reporting
Understand NCQA HEDIS specification updates and how measure logic changes year
over year
Are comfortable working with hybrid measures, including medical record/supplemental
data integration
Can trace a HEDIS rate back through the pipeline to its source claims/encounter data for
audit purposes
Have worked within HEDIS submission timelines and understand the compliance stakes
involved
Nice to Have
Experience with NCQA HEDIS audits or working alongside a certified HEDIS compliance
