HEDIS Data Analyst Remote, North Carolina

Posting Details

• Posted on January 9, 2026

• Home Office:
  Morrisville, NC 27560, USA
• Remote
• Devolp:
  Data, Analytics, & Interoperability
• Full-Time
• Requisition #: HEDIS
  003165

The HEDIS Data Analyst is responsible for working collaboratively with Quality Management, IT, and other teams across the organization to gather and document HEDIS data requirements for reporting, perform integrated testing for data quality assurance, support our organization’s HEDIS Data initiatives, and develop reports to support decision making and business processes. The HEDIS Data Analyst uses a certified HEDIS engine, SQL, and Microsoft office tools to enable deep dives and data quality review to improve HEDIS Ratings.

This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed.

HEDIS Analysis

• Perform activities, processes, and procedures to achieve improvement in HEDIS measures
• Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines
• Provide comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures to senior management
• Manage all clinical quality metrics and HEDIS processes and results
• Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
• Ensure compliance of all quality audits and maintain all data and process controls

Develop Reports and Data Visualization Solutions

• Perform data acquisition, analysis, evaluation, and analytics via advanced SQL queries and stored procedures, Micro Strategy, and other data management tools
• Design solutions using BI concepts including dynamic and parameter driven reporting, dashboards, data visualization, and alerts
• Using thorough knowledge of available data, design products that merge data from various sources including EDI files, HIE, State data, transactional system, and data warehouse
• Provide support, as required, to ensure the accuracy of developed reports and metrics for both external and internal users
• Ensure that reporting activities are conducted in ways that correspond with externally mandated specifications
• Assist the QM Department with HEDIS data assurance/integrity efforts required as part of larger quality activities, and with the completion and validation of HEDIS reports
• Perform geocoding activities through GIS software to analyze spatial statistics

Quality Assurance

• Actively participate in Data Governance committee and Business Analyst teams

Documentation

• Develop technical and business process documentation for HEDIS data and solutions

Experience and Education

Required:

• Bachelor’s degree from an accredited university in human services, statistics, mathematics, computer science, business administration or related field and three (3) years of experience in a Data or Business Analyst position with direct involvement in Healthcare HEDIS analytics and data.

Preferred:

• Experience in business application consulting or development, including experience in planning, facilitating, eliciting, documenting and managing business, functional and technical requirements.
• Managed care and quality improvement experience strongly preferred.
• Experience with insurance or healthcare industries is preferred.

• Communication skills
• Knowledge of data analysis on databases/data sets
• Excellent written communication skills, including technical writing and document design principles
• Advanced experience with SQL
• Microsoft Office, Visio, Microsoft Project and Microsoft Visual Studio skills
• Ability to analyze large data sets and perform data profiling
• Experience working with healthcare data
• Experience using a certified HEDIS engine
• Strong critical thinking and problem-solving skills
• Ability to work independently and in a team setting
• Ability to manage multiple priorities, and…