Healthcare Business Analyst (HEDIS & STARS)

Acess GlobalLouisville, KY, United States

5 days ago

Job type

Temporary

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Job description

Job Title : Healthcare Business Analyst (HEDIS & STARS)

Location : Louisville, KY (Onsite)

Duration : Long-Term Contract

Job Summary :

We are seeking an experienced Healthcare Business Analyst with a strong background in HEDIS and STARS programs to support quality improvement initiatives, data analysis, and performance reporting within the healthcare domain. The ideal candidate will have in-depth knowledge of healthcare quality metrics, data sources, and regulatory requirements for Medicare and Medicaid programs.

Key Responsibilities :

Serve as a liaison between business stakeholders, quality teams, and IT for HEDIS and STARS initiatives.
Analyze healthcare data to identify trends, gaps, and opportunities for improving quality measures and member outcomes.
Support the annual HEDIS data collection and validation process, ensuring compliance with NCQA guidelines.
Assist in Stars program performance analysis , measure tracking, and improvement planning.
Work closely with business users to gather and document requirements for reporting, dashboards, and process enhancements.
Collaborate with data teams to ensure accuracy and completeness of healthcare quality data.
Develop functional specifications and contribute to the testing and validation of HEDIS / Stars analytics solutions.
Prepare performance reports, presentations, and executive summaries for leadership review.
Stay current with CMS , NCQA , and other regulatory updates related to quality measurement.

Required Skills & Experience :

5+ years of experience as a Business Analyst in the Healthcare domain.

Strong knowledge of HEDIS , STARS , NCQA , and CMS quality measures .

Proficiency in data analysis tools (SQL, Excel, or BI platforms such as Power BI or Tableau).

Experience working with claims, eligibility, and provider data .

Understanding of healthcare workflows, quality programs, and risk adjustment models.

Excellent analytical, documentation, and communication skills.

Ability to work with cross-functional teams in a fast-paced environment.

Preferred Qualifications :

Bachelor's degree in Healthcare Administration , Information Systems , Public Health , or related field.

Experience with Medicare Advantage or Managed Care organizations.

Knowledge of ETL processes and data warehousing concepts .

Familiarity with Agile methodology and tools like JIRA or Confluence .

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Analyst • Louisville, KY, United States