HEDIS Data Quality Integrity Analyst

Job not on LinkedIn

🔥 18 hours ago

🦌 Connecticut, New Jersey, +2 more states – Remote

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🔔 Pennsylvania – Remote

💵 $109.6k - $149.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 14%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Horizon Connect @ Wall BCBSNJ

WebsiteLinkedInAll Job Openings

2 - 10 employees

⚕️ Healthcare Insurance

🏥 Healthcare

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ is a LinkedIn presence or local program/office associated with Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Based on the name and context, it appears to be connected to Horizon BCBSNJ’s health insurance operations and local outreach or member/provider engagement in the Wall, NJ area. Publicly available information provided is limited and mostly LinkedIn site chrome rather than a company profile, so this description is conservative and based on the affiliation indicated by the name.

📋 Description

• Serve as technical lead for designing and carrying out HEDIS data quality analytics • Design and implement a structured approach to data quality for accurate HEDIS member health-status data • Lead quality performance analytics, development, and reporting • Collect business requirements according to State, CMS, and NCQA specifications • Translate business requirements into analytics designs and define data and analytics specifications • Manipulate and analyze large healthcare datasets from various data sources • Interpret findings to identify opportunities and solutions that improve clinical quality, cost efficiency, and healthcare affordability • Lead projects designed to improve HEDIS, Stars, accreditation, and State performance • Own vendor relationships for vendors supporting quality performance • Build quality assurance criteria and processes to ensure regulatory reporting data is complete and accurate • Act as analytic liaison for complex clinical analytics projects involving multiple data resources and teams • Create integrated analytic datasets and summarize findings for business opportunities and questions • Provide insight and guidance on analytic findings, including root causes and contributing factors • Socialize analytics designs, results, and interpretations across analytical and business units • Document methods, specifications, findings, SAS coding comments, and analytic plans/timelines • Present analytics findings to internal leadership teams • Provide technical training to junior analysts in analytics design, data, programming, QA, statistics, and documentation

🎯 Requirements

• High School Diploma/GED required • Bachelor degree in Math, Statistics, Data Science, or Public Health preferred or relevant experience in lieu of degree • Minimum of 5 years of experience in data analytics, HEDIS, SAS or related field • Minimum of 5 years of experience performing analysis on healthcare data, HEDIS data or relational health care databases, with significant experience analyzing medical, pharmacy and behavioral data • Extensive knowledge of US healthcare industry, health plan business, claims data, clinical data, and coding practices • Knowledge and working experience of visualization and BI tools (e.g., Tableau) preferred • Strongly preferred SAS, SQL and Python experience • Proficiency with MS Excel for data analysis and reporting • Solid organizational skills and attention to detail • Ability to work in a fast-paced, team-oriented environment and manage competing priorities • Highly motivated and able to work independently

🏖️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement