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Astir IT Solutions, Inc. · 1 day ago

Senior Business Analyst – HEDIS (Principal Level) Only w2.

United States

Contract

Remote

Senior Level, Lead/Staff

15+ years exp

Astir IT Solutions, Inc. is seeking a Senior Business Analyst with deep expertise in NCQA HEDIS measures. The role involves leading requirements definition for HEDIS reporting, collaborating with various teams, and providing documentation to support quality reporting and regulatory compliance.

Information TechnologyOutsourcingSoftware

Senior Management

H1B Sponsor Likely

Hiring Manager

Hari J

Responsibilities

HEDIS SME with hands-on experience interpreting NCQA specifications, annual updates, exclusions, and audit requirements

Lead requirements definition and validation for HEDIS reporting, submissions, and audits

Strong collaboration with clinical, quality, analytics, and IT teams to ensure correct measure implementation

Expertise working with claims, encounters, clinical/EHR, pharmacy, and lab data

Experience supporting CMS quality programs (Stars, QRS) and understanding their alignment with HEDIS

Identify data quality gaps, risks, and improvement opportunities impacting quality performance

Deliver high-quality documentation (BRDs, FRDs, data mappings, measure logic)

Trusted advisor to stakeholders and leadership on healthcare quality and regulatory initiatives

Qualification

HEDIS expertiseHealthcare experienceNCQA specificationsData quality analysisCMS quality programsStakeholder managementCollaboration skillsDocumentation skills

Required

Minimum 15+ Years of Experience required

10+ years of healthcare experience

Deep expertise in NCQA HEDIS measures

Proven track record translating complex HEDIS technical specifications into clear business, functional, and data requirements to support accurate quality reporting and regulatory compliance