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Alliance Health · 3 weeks ago

HEDIS Data Analyst (Full Time, Remote, North Carolina Based)

United States

Full-time

Remote

Mid Level

$68K/yr - $90K/yr

3+ years exp

Alliance Health is seeking a HEDIS Data Analyst who will work collaboratively with Quality Management, IT, and other teams to gather and document HEDIS data requirements. The role involves performing data quality assurance, supporting HEDIS data initiatives, and developing reports to aid decision-making and business processes.

Health Care

Responsibilities

Perform activities, processes, and procedures to achieve improvement in HEDIS measures

Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines

Provide comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures to senior management

Manage all clinical quality metrics and HEDIS processes and results

Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities

Ensure compliance of all quality audits and maintain all data and process controls

Perform data acquisition, analysis, evaluation, and analytics via advanced SQL queries and stored procedures, MicroStrategy, and other data management tools

Design solutions using BI concepts including dynamic and parameter driven reporting, dashboards, data visualization, and alerts

Using thorough knowledge of available data, design products that merge data from various sources including EDI files, HIE, State data, transactional system, and data warehouse

Provide support, as required, to ensure the accuracy of developed reports and metrics for both external and internal users

Ensure that reporting activities are conducted in ways that correspond with externally mandated specifications

Assist the QM Department with HEDIS data assurance/integrity efforts required as part of larger quality activities, and with the completion and validation of HEDIS reports

Perform geocoding activities through GIS software to analyze spatial statistics

Actively participate in Data Governance committee and Business Analyst teams

Develop technical and business process documentation for HEDIS data and solutions

Qualification

HEDIS analyticsSQLData visualizationMicrosoft OfficeData analysisHealthcare dataCommunication skillsCritical thinkingProblem-solvingTeamwork

Required

Bachelor's degree from an accredited university in human services, statistics, mathematics, computer science, business administration or related field

Three (3) years of experience in a Data or Business Analyst position with direct involvement in Healthcare HEDIS analytics and data

Communication skills

Knowledge of data analysis on databases/data sets

Excellent written communication skills, including technical writing and document design principles

Advanced experience with SQL

Microsoft Office, Visio, Microsoft Project and Microsoft Visual Studio skills

Ability to analyze large data sets and perform data profiling

Experience working with healthcare data

Experience using a certified HEDIS engine

Strong critical thinking and problem-solving skills

Ability to work independently and in a team setting

Ability to manage multiple priorities, and assess and adjust quickly to changing priorities

Preferred

Experience in business application consulting or development, including experience in planning, facilitating, eliciting, documenting and managing business, functional and technical requirements

Managed Care And Quality Improvement Experience Strongly Preferred

Experience with insurance or healthcare industries is preferred