Business Analyst, HEDIS HealthCare

Job Description

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 Show more Show less