HEDIS Analyst (Remote Option)

About the position The HEDIS Analyst serves as a key analytical partner supporting HEDIS quality measurement, audit readiness, and performance improvement initiatives. This role requires close, ongoing collaboration with the HEDIS Manager to ensure alignment on quality measures, regulatory compliance, and timely, accurate reporting to internal stakeholders and provider partners. The ideal candidate brings strong technical expertise in SQL, Power BI, and cloud data platforms (Snowflake preferred), with demonstrated experience supporting healthcare quality programs. Familiarity with HEDIS specifications, audit workflows, and payer-provider data flows is strongly preferred.

Responsibilities

• Work in close partnership with the HEDIS Manager to support audit readiness, quality reporting, and compliance initiatives, including HEDIS Audit, Performance Measure Validation (PMV), CAHPS, and accreditation activities.
• Collaborate with cross-functional teams (Quality, IT, Clinical, Provider Relations) to gather analytical requirements and translate them into accurate, actionable insights.
• Provide clear documentation, user training, and ongoing support to ensure analytics are understood and effectively utilized by business partners.
• Design, develop, and maintain interactive dashboards and performance reports using Power BI, including advanced DAX calculations and AI-enabled visuals.
• Conduct deep-dive analyses to identify trends, performance drivers, gaps, and root causes impacting quality outcomes.
• Apply Python for advanced analytics, statistical analysis, and custom visualizations as needed.
• Optimize dashboard performance and manage data refresh schedules to ensure reliability and scalability.
• Extract, clean, and transform data from multiple sources, including SQL databases, Excel files, and cloud platforms (e.g., Snowflake).
• Build and maintain high-quality Power BI data models, including calculated columns, measures, and Row-Level Security (RLS).
• Ensure data accuracy, integrity, and governance, with strict adherence to HIPAA and PHI handling requirements.
• Support HEDIS-related performance improvement projects through analytical insights and statistical analysis.
• Apply knowledge of HEDIS measure specifications, payer-provider data flows, and validation techniques to ensure audit-ready outputs.
• Participate in audit preparation activities, including documentation support, data validation, and response to auditor inquiries.

Requirements

• Strong proficiency in SQL for querying and analyzing large healthcare datasets.
• Advanced experience with Power BI, including data modeling, DAX, RLS, and performance optimization.
• Experience working with cloud data platforms (Snowflake preferred; Databricks a plus).
• Working knowledge of U.S. healthcare data models (claims, clinical, lab, immunization, quality measures).
• Strong analytical skills with the ability to identify data issues, troubleshoot inconsistencies, and recommend practical solutions.
• Demonstrated attention to detail, time management, and ability to independently carry tasks through to completion.
• Strong communication skills, with the ability to explain complex data findings to non-technical stakeholders.
• Bachelor’s degree in Computer Science, Data Analytics, Health Informatics, ora related field.
• Minimum of four (4) years of experience in analytics, reporting, or business intelligence, with Power BI experience required.

Nice-to-haves

• Familiarity with HEDIS audits, PMV, CAHPS, and accreditation processes.
• Experience supporting healthcare quality or value-based performance programs.
• Experience with Python for analytics or statistical analysis.
• Knowledge of data validation, profiling, and standardization techniques in regulated environments.
• Experience in healthcare payer or managed care environments.

Benefits

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer

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