Business Intelligence Analyst, HEDIS Data Operations

Job Description

What You'll Do

• Ensure the accuracy and reliability of data utilized in quality management to support data extraction process

• Collaborate with cross-functional teams to define standard HEDIS data requirements and implement process improvements to integrate and expand new data sources

• Analyze HEDIS /Clinical related data trends and provide actionable insights that drive informed decision-making

• Conduct system testing, debugging, and documentation to maintain high-quality standards

• Ensure compliance with HEDIS regulatory standards and internal quality control processes

• Partner with auditors and external stakeholders during the HEDIS audit process, addressing data requests and ensuring compliance

• Document data flow processes, coding standards, and HEDIS measure interpretations to ensure clarity and collaboration across teams
•  Validate annual updates and revisions to HEDIS certified software for data inputs and outputs
• Proficient in monitoring and analyzing data volumes across claims, enrollment, member records and pharmacy to ensure accuracy and efficiency
• Collaborate with Data Engineers and Data Scientists to identify, create and influence optimal solution design to deliver actionable insight related HEDIS measure quality metrics

• Facilitate cross-functional problem-solving sessions to arrive at optimal solutions accounting for stakeholder needs to ensure successful project delivery
• Create, maintain, and enforce data visualization governance and development standards to continuously and proactively improve the quality of solution development and efficiency of processes across the enterprise

What You'll Bring

• Bachelor's degree or advanced degree (where required)
• 3+ years of experience in related field
• In lieu of degree, 5+ years of experience in related field

Bonus Points

• Proven experience as an Analyst, preferably in quality data management or a similar field
• Proficient in programming languages such as SQL, Python, R, or similar
• Experience with data management systems and tools (e.g., SQL databases, ETL tools, data visualization software)
• Strong analytical skills with attention to detail
• Familiarity with quality control processes and standards (ISO, Six Sigma, etc.) is a plus

What You'll Get

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community  

• Work-life balance, flexibility, and the autonomy to do great work   

• Medical, dental, and vision coverage along with numerous health and wellness programs   

• Parental leave and support plus adoption and surrogacy assistance   

• Career development programs and tuition reimbursement for continued education   

• 401k match including an annual company contribution   

• Learn more   

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets,  licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. 

*Based on annual corporate goal achievement and individual performance.
 

Skills