Data Analyst (Piscataway)

Role : HEDIS Data Analyst

Location : Piscataway, NJ

Key Responsibilities

• Must have HEDIS Analytics & Reporting
• Develop, validate, and maintain HEDIS measure calculations based on NCQA specifications.
• Extract, transform, and analyse data from claims, eligibility, EHR, pharmacy, and lab systems.
• Support annual HEDIS submissions, including numerator / denominator validation, audit documentation, and data quality checks.
• Conduct trending, gap analysis, and performance monitoring for all HEDIS measures.
• Generate weekly / monthly dashboards for stakeholder consumption.
• Data Engineering & ETL Support
• Develop and optimize SQL queries, ETL pipelines, and data transformations.
• Collaborate with IT / data engineering teams to improve data quality and resolve inconsistencies.
• Create field mappings, data lineage documentation, and technical specifications.
• Chart Review / Hybrid Measures
• Produce and manage provider retrieve lists for medical record collection.
• Validate chart abstraction output for accuracy and completeness.
• Support provider outreach related to missing documentation and care gaps.
• Cross-Functional Collaboration
• Partner with Quality Improvement, Clinical, Provider Relations, and Compliance teams to support initiatives.
• Provide guidance on data anomalies, measure interpretation, and technical HEDIS questions.
• Present insights and trend analyses to leadership.
• Audit & Compliance
• Assist with HEDIS Compliance Audit preparation and documentation.
• Ensure adherence to NCQA guidelines and regulatory requirements.
• Maintain audit trails and detailed reporting artifacts.

Technical Skills

HEDIS / Healthcare Domain Knowledge