HEDIS Data Analyst

Derex Technologies Inc

HEDIS Data Analyst developing and validating HEDIS measures, analyzing data, and supporting regulatory compliance tasks for healthcare provider. Collaboration with various teams to ensure quality and accuracy.

Posted 7/9/2026full-timeRemote • Newark • New Jersey • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in developing and validating HEDIS measures according to NCQA specifications, with a strong focus on SQL query optimization, data analysis, and regulatory compliance in healthcare settings.

Highest-signal resume keywords

Advanced SQLHEDIS Measure DevelopmentHealthcare Payer DatasetsNCQA Audit PreparationCoding Standards Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

SQL Query OptimizationData TransformationETL Pipeline DevelopmentData Quality ImprovementChart Abstraction Validation

Soft Skills

CollaborationCommunicationAnalytical Thinking

Industry Keywords

NCQA HEDIS SpecsClaims DataEligibility DataEMR DataPharmacy DataLab DataCare Gap WorkflowsCMS Star RatingsAudit ProcessesHybrid Measures

Tech Stack

Tools & technologies

ETLSQL

About the role

Key responsibilities & impact

Develop/validate HEDIS measures per NCQA specs, analyze claims/eligibility/EHR/pharmacy/lab data, support annual submissions, audits, and dashboards.
Build/optimize SQL queries, ETL pipelines, and data transformations; improve data quality; document lineage and mappings.
Manage provider lists, validate chart abstraction, support outreach for care gaps.
Work with Quality, Clinical, Provider Relations, and Compliance teams; provide guidance on anomalies; present insights to leadership.
Assist with NCQA audit prep, ensure regulatory adherence, maintain audit trails and reporting artifacts.

Requirements

What you’ll need

Advanced SQL (required)
Experience with healthcare payer datasets (claims, eligibility, provider, EMR, pharmacy, lab)
Knowledge of coding standards (ICD‑10, CPT, HCPCS, LOINC, NDC)
Deep understanding of NCQA HEDIS specs
Experience with hybrid & administrative measures
Familiarity with audit processes, care gap workflows, and CMS Star Ratings

Benefits

Comp & perks

All your information will be kept confidential according to EEO guidelines.