Senior HEDIS Technical Analyst

6 days ago

🦞 Maine – Remote

Although this job is listed in Maine, this company may be open to hiring remote in other states.

⏰ Full Time

🟠 Senior

📞 Support Engineer

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Martin's Point Health Care

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Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

TRICARE Prime • Medicare Advantage • Medicare Part D • Health Care • Primary Care

501 - 1000 employees

⚕️ Healthcare Insurance

🧘 Wellness

📋 Description

• Join Martin's Point Health Care, a not-for-profit health care organization. • Serve as a critical bridge between HEDIS technical specifications, data infrastructure, and business stakeholders. • Translate complex HEDIS measure requirements into actionable data strategies. • Write T-SQL queries for accurate data extraction and transformations. • Collaborate with data engineers, architects, analysts, and quality teams. • Optimize data builds and validate measure calculations. • Support regulatory compliance and enhance automation processes. • Troubleshoot data discrepancies and oversee digital quality transitions. • Ensure proper use and protection of information assets. • Perform complex quality assurance testing and document specifications.

🎯 Requirements

• Bachelor’s degree in health sciences, Master’s degree preferred. • 5+ years of experience in the health care industry, in HEDIS and/or quality improvement. • Experience in managed care health services environment. • Experience programming HEDIS or HEDIS like measures. • NCQA and HEDIS Experience. • Required License(s) and/or Certification(s): Certified Professional in Healthcare Quality, preferred. • Demonstrated knowledge of data collection, transformation and quality assurance. • Ability to extract, cleanse, integrate medical and pharmacy claims and membership data from various platforms and sources. • Excellent communication, organization and writing skills. • Ability to effectively prioritize work, multi-task, and achieve goals on time; work independently and to self-motivate. • Excellent critical thinking skills. • Keen attention to detail. • Ability to work effectively and collaboratively with internal and external stakeholders. • Knowledge of, and skills in, data collection, analysis, and presentation. • Excellent oral and written communication skills. • Must demonstrate integrity, sound judgement and strong interpersonal skills. • Strong knowledge of medical terminology. • Strong clinical knowledge and understanding of evidenced-based practice principles and the ability to define appropriate sources for standards of care. • Must be able to address quality issues with tact and diplomacy. • Proficient use of MS Office with a focus on Excel and report writing software. • Proficiency in use of electronic medical records and computer applications. • Ability to use data to make decisions.