Hedis Healthcare Analyst with SQL Experience

Technical Skills:

• Advanced SQL (complex joins, aggregations, data reconciliation, performance tuning)
• Data profiling and validation techniques (completeness, accuracy, consistency checks)
• Experience working with large-scale data platforms (e.g., Snowflake, SQL Server)
• Ability to analyze and validate data transformations and source-to-target mappings
• Strong troubleshooting skills for data issues across multiple datasets
• Healthcare Data Experience.
• Experience working with healthcare claims data (claim header and line-level structures)

Understanding of:

• Diagnosis codes (ICD)
• Procedure codes (CPT/HCPCS)
• Provider data and attributes
• Familiarity with member/eligibility data and linking to claims
• Exposure to Medicare and/or Medicaid data preferred
• HEDIS / Quality Reporting (Strongly Preferred)
• Understanding of HEDIS data inputs and measure logic
• Experience supporting quality reporting or regulatory submissions
• Ability to validate measured outputs and investigate rate variances
• Data Management & Testing Skills
• Experience with data mapping and transformation validation
• Strong data defect triage and root cause analysis