| Job Description: |
We need an onshore person with strong hands on HEDIS healthcare experience and SQL. GC/US citizen only. Strong hands on experience needed - Data analysis, data troubleshooting, data migration, incident Triaging, strong SQL ,healthcare domain knowledge, production support, data transformation, CMS part a, b, c.
Technical and domain knowledge needed below. 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 measure outputs and investigate rate variances
Data Management & Testing Skills - Experience with data mapping and transformation validation
- Strong data defect triage and root cause analysis
- Experience supporting:
- User Acceptance Testing (UAT)
- Parallel system validation (e.g., source vs. target comparisons)
- Ability to reconcile outputs across systems and identify discrepancies
Analytical & Problem-Solving Skills - Strong critical thinking and analytical reasoning
- Ability to break down complex data issues into root causes
- Experience working with incomplete or ambiguous data scenarios
- Ability to assess downstream impact of data issues on reporting
Collaboration & Communication - Ability to work cross-functionally with Data Engineering, business stakeholders, and vendors
- Strong written communication skills for:
- Documenting data issues
- Writing clear defect descriptions
- Explaining findings to non-technical stakeholders
Nice-to-Have Skills - Experience with ClaimSphere or similar HEDIS engines
- Familiarity with Facets or healthcare adjudication platforms
- Experience working in cloud data environments
- Exposure to Power BI or report validation
- Understanding of data governance concepts (data definitions, lineage, stewardship)
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