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HEDIS Analyst/Consultant

E-Solutions, Inc.United States🇺🇸United States

Why this role stands out

This role offers a fantastic opportunity to elevate your healthcare analytics career by leveraging your expertise in HEDIS, actuarial data, and SQL within a flexible, remote-first environment. You will thrive in this position if you are a detail-oriented professional passionate about driving quality outcomes and uncovering actionable insights through complex data mapping. Apply today to make a significant impact on healthcare performance and take the next step in your professional growth.

Quick overview

SeniorityMid Senior
Work modeHybrid
LocationUnited States
SQLSnowflakeUnderwritingData Analysis

Job description

Hi Professionals,
Title: HEDIS Analyst/Consultant
Locattion: Remote
JD:
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Must-Have:

  • US Healthcare Payer
  • Actuarial
  • Underwriting
  • HEDIS / Quality
  • Claims & Enrollment Data
  • PMPM / MLR / IBNR / Risk Adjustment
  • SQL & Data Profiling
  • Data Lineage / Data Mapping
  • Business Rule Discovery
  • Reverse Engineering
  • Healthcare Analytics / Data Modernization
  • Snowflake (Preferred)
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    Key Requirements:

    • Strong US Healthcare Payer domain expertise
    • Experience with Actuarial, Underwriting & HEDIS/Quality
    • Knowledge of payer metrics: PMPM, MLR, IBNR, Risk Adjustment, Cost & Utilization
    • Hands-on experience with Claims, Membership, Provider, Premium & Clinical data
    • Strong SQL, Data Analysis & Data Profiling skills
    • Ability to reverse engineer business rules, data flows, lineage & mappings
    • Bridge communication between business SMEs and technical teams
    • Healthcare analytics, transformation, or data modernization experience preferred
    • Exposure to Snowflake, Semantic Modeling, Metadata Management, AI-enabled Analytics is a plus

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HEDIS Analyst/Consultant1HEDIS Analyst/Consultant,US Healthcare Payer Actuarial Underwriting HEDIS / Quality Claims & Enrollment Data PMPM / MLR / IBNR / Risk Adjustment SQL & Data Profiling Data Lineage / Data Mapping Business Rule Discovery Reverse Engineering Healthcare Analytics / Data ModernizaN/AC2CUnited States

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