About the job

Business Analyst

Requirements

• The SDS Business Analyst will be responsible for management of supplemental data

• sources (SDS), including audit documentation, HEDIS technical specification review, and

• tracking of supplemental data sources. This role requires collaboration with appropriate

• areas of the business to ensure the most efficient management of data with the highest level

• of quality and greatest Enterprise gain. All work supports Commercial, Medicare & Medicaid

• lines of business. Additionally, this role will support process improvement through the

• identification of data source opportunities for improvement and development of associated

action plans.

1. Primary Responsibilities:

Source Management

• Knowledgeable of clinical supplemental data sources as used in HEDIS® data
• processing - purpose, intent of use, data collection method
• Responsible for audit documentation completion and quality of documentation
• Responsible for medical record requests to support medical record review or primary
• source verification - related to HEDIS® audit
• Knowledgeable of NCQA HEDIS® technical specifications regarding supplemental
• data and applicable measures
• Responsible for tracking of source documentation readiness
• Data Management
• Maintain documentation of end-to-end data flow of sources
• Knowledgeable of data validation reports of sources
• Awareness of data load specifications to HEDIS® rules engines
• Audit Management
• Maintain documentation of audit review outcome by source
• Support Quality Solutions Delivery with HEDIS® audit - for all audit groups involved
• with annual audit -- address audit issues/concerns within required turnaround time
• Complete work on time, especially as it pertains to HEDIS® audit deadlines
• Other Responsibilities:
• Develop & produce ad-hoc reports
• Participate with complex analyses and reports
• Works independently; seeks guidance on only the most complex tasks