Senior Business Analyst - Health Care (HEDIS)

Title -                   Senior Business Analyst - Health Care (HEDIS)

Location -           Philadelphia, PA (Hybrid)

Duration -           Long term Contract

Must Have

• Lead requirements end to end, independently driving discovery, analysis, and solution definition across business and IT stakeholders.
• Serve as a subject matter expert on HL7 exchange protocols, including FHIR, CCDs, ADTs, etc.
• Perform hands on data analysis using SQL, Databricks, and related tools to validate data, troubleshoot issues, and support design decisions.
• Prior Experience on `HEDIS and Quality process and HEDIS Data is a plus.
• Document business and technical requirements, source to target mappings, data specifications, business rules, and process flows.
• Support validation and QA by reviewing data outputs, test cases, and results to ensure accuracy and compliance.
• Collaborate with internal teams and external partners with minimal supervision to gather requirements, drive key decisions, and support successful implementations.
• Mentor and guide junior BAs on best practices in requirements, documentation, analysis, and stakeholder engagement.
• Communicate business and process solutions, recommendations, and issues to client management on a regular basis.
• Document all business process flows related to interoperability initiatives.
• Apply working knowledge of internal customer Managed Care functions (HealthCare Services, Claims, Enrolment, Quality/HEDIS, Risk Adjustment, Care Management, Utilization Management) to support problem solving and solution design.