Clinical Informaticist / Clinical Informatics Analyst – HEDIS & Interoperability

Role Summary

We are seeking an experienced Clinical Informaticist to bridge clinical practice and technology by translating clinical workflows, healthcare data, and regulatory standards into effective digital solutions. The ideal candidate will possess strong expertise in Clinical Informatics, HEDIS/NCQA quality measures, healthcare interoperability, and clinical data standards.

This role will work closely with clinical stakeholders, product owners, engineering teams, and data teams to ensure clinical systems, analytics, and reporting solutions are accurate, interoperable, compliant, and aligned with care delivery objectives.

Key Responsibilities

• Act as a liaison between clinical stakeholders and technical teams
• Analyze and document clinical workflows, use cases, and healthcare data requirements
• Translate clinical and operational needs into functional, technical, and reporting specifications
• Support implementation and optimization of clinical systems and digital health solutions
• Ensure accurate use and interpretation of clinical terminologies, coding systems, and healthcare standards
• Support interoperability and healthcare data exchange initiatives across systems and platforms
• Validate clinical data outputs for accuracy, consistency, audit readiness, and usability
• Participate in testing, UAT, defect validation, and clinical sign-off activities
• Support clinical quality initiatives, HEDIS reporting, analytics, and compliance use cases
• Contribute to clinical governance, documentation standards, and best practices
• Collaborate within Agile/Scrum delivery teams and participate in sprint planning and execution

Required Skills & Experience

• 7+ years of experience in Clinical Informatics / Healthcare Informatics
• Strong understanding of clinical workflows and healthcare data ecosystems
• Experience with healthcare interoperability standards such as FHIR and HL7
• Hands-on knowledge of clinical terminologies and coding systems including:
  • SNOMED
  • ICD-10
  • CPT
  • LOINC
• Experience working with clinical systems, EHR/EMR platforms, or Health IT solutions
• Strong analytical, documentation, and communication skills
• Experience collaborating with engineering, product, analytics, and data teams
• Experience working in Agile or SDLC-based delivery models

Preferred / Highly Desired Skills

• Deep knowledge of NCQA HEDIS measures
• Strong expertise in:
  • EED (Eye Exam for Patients with Diabetes)
  • OMW (Osteoporosis Management in Women Who Had a Fracture)
• Understanding of:
  • Eligibility logic
  • Look-back periods
  • Audit defensibility
  • Clinical quality reporting
• Experience with population health, payer systems, or value-based care initiatives
• Exposure to healthcare analytics and regulatory compliance reporting