Location: Philadelphia ,PA – Hybrid – 3 Days a week in
the office/ Remote
Duration: Long-Term Contract
Job Summary
We are seeking a detail-oriented HEDIS Data Analyst with
strong SQL skills to support Healthcare Effectiveness Data and
Information Set (HEDIS) reporting, quality improvement initiatives, and
healthcare data analysis. The ideal candidate will have experience working with
healthcare data, analyzing HEDIS measures, validating data accuracy, and
developing SQL queries to support reporting, compliance, and performance
improvement.
Key Responsibilities
Analyze and validate
HEDIS (Healthcare Effectiveness Data and Information Set) measures to
support quality improvement and regulatory reporting.
Develop, write,
optimize, and maintain complex SQL queries for healthcare data extraction,
validation, and reporting.
Perform data analysis to
identify trends, gaps in care, and opportunities for quality improvement.
Validate data accuracy
and ensure compliance with HEDIS specifications and organizational
standards.
Collaborate with
quality, clinical, business, and IT teams to support HEDIS reporting
initiatives.
Perform data
reconciliation, quality assurance, and root cause analysis of data
discrepancies.
Support annual HEDIS
submission activities, including data validation and audit preparation.
Create reports,
dashboards, and data summaries to support leadership decision-making.
Monitor data quality and
recommend process improvements to improve reporting accuracy.
Document SQL queries,
data mapping, business rules, and reporting processes.
Assist with
troubleshooting data issues and resolving reporting discrepancies.
Ensure compliance with
HIPAA and healthcare data privacy regulations.
Required Qualifications
Bachelor's degree in
Computer Science, Information Systems, Healthcare Informatics, Data
Analytics, or a related field (or equivalent experience).
3+ years of experience
working with HEDIS reporting or healthcare quality data.
Strong hands-on
experience writing and optimizing SQL queries.
Experience analyzing
large healthcare datasets.
Knowledge of HEDIS
measures, quality reporting, and healthcare data standards.
Strong analytical,
problem-solving, and data validation skills.
Excellent communication
and documentation skills.
Preferred Qualifications
Experience with managed
care, health plans, or payer organizations.
Familiarity with NCQA
HEDIS specifications and reporting guidelines.
Experience with
healthcare data warehouses and reporting tools.
Knowledge of claims,
provider, member, and clinical data.
Experience with ETL
processes and data integration.
Experience with BI tools
such as Power BI, Tableau, or SSRS.
Required Skills
HEDIS (Healthcare
Effectiveness Data and Information Set)
SQL
Database Querying
Healthcare Data Analysis
Data Validation
Data Quality
Reporting &
Analytics
Healthcare Quality
Measures
Claims Data Analysis
Clinical Data Analysis
NCQA HEDIS Guidelines
Data Reconciliation
Root Cause Analysis
Dashboard Development
HIPAA Compliance
Microsoft SQL Server /
Oracle / PostgreSQL (as applicable)
Problem Solving
Documentation
Healthcare Informatics
Quality Improvement
Information
Locations Hybrid/ RemotePosition Open to Anywhere in the US, but will work on-siteIndustry IT StaffingStatus OpenJob Age 31 Day'sCreated Date 07/06/2026No.of Positions 1Duration 12 MonthsZip Code
