Business Analyst, HEDIS HealthCare
2 weeks ago
Business Analyst
Requirements
The SDS Business Analyst will be responsible for management of supplemental data
sources (SDS), including audit documentation, HEDIS technical specification review, and
tracking of supplemental data sources. This role requires collaboration with appropriate
areas of the business to ensure the most efficient management of data with the highest level
of quality and greatest Enterprise gain. All work supports Commercial, Medicare & Medicaid
lines of business. Additionally, this role will support process improvement through the
identification of data source opportunities for improvement and development of associated
action plans.
Primary Responsibilities:
Source Management
Knowledgeable of clinical supplemental data sources as used in HEDIS data
processing – purpose, intent of use, data collection method
Responsible for audit documentation completion and quality of documentation
Responsible for medical record requests to support medical record review or primary
source verification – related to HEDIS audit
Knowledgeable of NCQA HEDIS technical specifications regarding supplemental
data and applicable measures
Responsible for tracking of source documentation readiness
Data Management
Maintain documentation of end-to-end data flow of sources
Knowledgeable of data validation reports of sources
Awareness of data load specifications to HEDIS rules engines
Audit Management
Maintain documentation of audit review outcome by source
Support Quality Solutions Delivery with HEDIS audit – for all audit groups involved
with annual audit -- address audit issues/concerns within required turnaround time
Complete work on time, especially as it pertains to HEDIS audit deadlines
Other Responsibilities:
Develop & produce ad-hoc reports
Participate with complex analyses and reports
Works independently; seeks guidance on only the most complex tasks
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