HEDIS Data Analyst

Data AnalystData AnalystFull TimeRemoteSeniorTeam 51-200Since 1996H1B SponsorCompany SiteLinkedIn

Location

New Jersey

Posted

20 hours ago

Salary

0

Seniority

Senior

EnglishETLSQL

Job Description

HEDIS Data Analyst

Derex Technologies Inc

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

Job Requirements

  • Advanced SQL (required)
  • Experience with healthcare payer datasets (claims, eligibility, provider, EMR, pharmacy, lab)
  • Knowledge of coding standards (ICD‑10, CPT, HCPCS, LOINC, NDC)
  • Deep understanding of NCQA HEDIS specs
  • Experience with hybrid & administrative measures
  • Familiarity with audit processes, care gap workflows, and CMS Star Ratings

Benefits

  • All your information will be kept confidential according to EEO guidelines.

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