HEDIS Analyst/Consultant

Remote • Posted 23 hours ago • Updated 23 hours ago
Contract W2
Contract Corp To Corp
Contract Independent
12 Months
No Travel Required
Remote
Depends on Experience
Fitment

Dice Job Match Score™

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Job Details

Skills

  • US Healthcare Payer Actuarial Underwriting HEDIS / Quality Claims & Enrollment Data PMPM / MLR / IBNR / Risk Adjustment SQL & Data Profiling Data Lineage / Data Mapping Business Rule Discovery Reverse Engineering Healthcare Analytics / Data Modernization Snowflake (Preferred)

Summary

Hi Professionals,

Title: HEDIS Analyst/Consultant

Locattion: Remote

JD:
 

Must-Have:

  • US Healthcare Payer
  • Actuarial
  • Underwriting
  • HEDIS / Quality
  • Claims & Enrollment Data
  • PMPM / MLR / IBNR / Risk Adjustment
  • SQL & Data Profiling
  • Data Lineage / Data Mapping
  • Business Rule Discovery
  • Reverse Engineering
  • Healthcare Analytics / Data Modernization
  • Snowflake (Preferred)


    Key Requirements:

    • Strong US Healthcare Payer domain expertise
    • Experience with Actuarial, Underwriting & HEDIS/Quality
    • Knowledge of payer metrics: PMPM, MLR, IBNR, Risk Adjustment, Cost & Utilization
    • Hands-on experience with Claims, Membership, Provider, Premium & Clinical data
    • Strong SQL, Data Analysis & Data Profiling skills
    • Ability to reverse engineer business rules, data flows, lineage & mappings
    • Bridge communication between business SMEs and technical teams
    • Healthcare analytics, transformation, or data modernization experience preferred
    • Exposure to Snowflake, Semantic Modeling, Metadata Management, AI-enabled Analytics is a plus



HEDIS Analyst/Consultant1HEDIS Analyst/Consultant,US Healthcare Payer Actuarial Underwriting HEDIS / Quality Claims & Enrollment Data PMPM / MLR / IBNR / Risk Adjustment SQL & Data Profiling Data Lineage / Data Mapping Business Rule Discovery Reverse Engineering Healthcare Analytics / Data ModernizaN/AC2CUnited States
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: 10211255
  • Position Id: 247883-14311-1790901267
  • Posted 23 hours ago
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