HEDIS Data Analyst
Job Location:
Newark, DE - USA
Monthly Salary:
Posted on:
Vacancies:
Job Summary
Role: HEDIS Data Analyst
Location: Newark NJ or nearby (remote 24 days/month onsite)
Key Responsibilities:
- HEDIS Analytics Develop/validate HEDIS measures per NCQA specs analyze claims/eligibility/EHR/pharmacy/lab data support annual submissions audits and dashboards.
- Data Engineering Build/optimize SQL queries ETL pipelines and data transformations; improve data quality; document lineage and mappings.
- Chart Review Manage provider lists validate chart abstraction support outreach for care gaps.
- Collaboration Work with Quality Clinical Provider Relations and Compliance teams; provide guidance on anomalies; present insights to leadership.
- Audit & Compliance Assist with NCQA audit prep ensure regulatory adherence maintain audit trails and reporting artifacts.
Technical Skills:
- Advanced SQL (required)
- Experience with healthcare payer datasets (claims eligibility provider EMR pharmacy lab)
- Knowledge of coding standards (ICD10 CPT HCPCS LOINC NDC)
Domain Knowledge:
- Deep understanding of NCQA HEDIS specs
- Experience with hybrid & administrative measures
- Familiarity with audit processes care gap workflows and CMS Star Ratings
Regards
Manoj Goud
Derex Technologies INC
Contact : Ext 206
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Remote Work :
Yes
Employment Type :
Full-time
About Company
Derex Technologies Inc specializes in providing IT consulting, staffing solutions and software services. Globally headquartered in Harrison New Jersey since 1996 Derex delivers the highest quality technology professionals and an array of customized IT talent solutions designed to impr ... View more
