Business Analyst, HEDIS HealthCare

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