Clinical Data Analyst

Innovative Systems Group; Illinois; On-site; USD 54,000 - 77,000; Full time

Job summary

Innovative Systems Group is hiring for a HEDIS data quality analyst to support data collection, auditing, and validation of healthcare records for HEDIS compliance. You will audit EMR and non-EMR data, ensure accuracy of coding and measure values, and drive improvements in HEDIS results.

The role requires strong knowledge of HEDIS reporting, NCQA measures, and experience with CPT II, SNOMED, LOINC, ICD, HCPCS coding. Excellent communication and MS Office skills are needed.

Qualifications

• Experience with HEDIS reporting and NCQA/quality measures.
• Familiar with SHEDIS value sets and related code sets (CPT II, SNOMED, LOINC, ICD, HCPCS).
• Strong clinical data auditing experience in healthcare.
• Proficient in MS Office and data reporting tools.

Responsibilities

• Support data collection of HEDIS datasets to meet regulatory requirements.
• Audit and review electronic medical records for accuracy against documentation.
• Oversee and review data from EMRs and other sources to improve HEDIS results.
• Communicate complex findings to technical and non-technical audiences.

Skills

HEDIS reporting

NCQA

HEDIS codes

CPT II

SNOMED

LOINC

ICD

HCPCS

EMR systems

Data analysis

Auditing

MS Office

Healthcare experience

Communication

Tools

MS Office Suite

EMR systems

Reporting tools

Job description

Pay rate: $47.50/hr on W2 ; $95k conversion salary

Description:

This position supports the data collection of HEDIS clinical data set tied to technical specifications; auditing and review of electronic clinical records to ensure data accurately reflect medical record documentation to meet HEDIS regulatory compliance. Responsible for oversight and review of clinical data from Electronic Medical Records (EMRs) non-EMRs sources; auditing supplemental data files supplied by providers and vendors to improve HEDIS rates/results. This position impacts the integrity of the Medical Record validation process and HealthCare Effective Data & Information Set (HEDIS) Reporting.

• Strong Knowledge of Healthcare Effective Data & Information Set (HEDIS) type of reporting
• Minimum of 3 year’s Healthcare industry experience; healthcare data
• Strong experience with NCQA and HEDIS reporting, technical data analysis in formal audit formal audit environment.
• Understanding of NCQA HEDIS quality measures and related code value sets.
• Experience in HEDIS value sets and codes applied, including CPT II, SNOMED, LOINC, ICD, HCPCS, and other code sets.
• Strong clinical quality auditing experience
• Strong written and verbal skills; Self-starter problem solving abilities.
• Strong proficiency in MS Office Suite including Word, Excel, PowerPoint, datasets, reporting tools with good multi-tasking skills
• Strong understanding of Electronic Medical Record (EMRs) system from providers, vendors related to HEDIS interpretation
• Conducts analysis and investigation on inquiries related to medical records data collection issues
• Proven to be adept at navigating new systems and technology with little impact to your daily assignments
• Experience with Coding or Certified Coding Certification with HEDIS experience
• Familiar with HIX (Health Insurance Exchange) and EHR (Electronic Health Record) types of data collection.
• Strong interpersonal skill set including ability to support in partner relationship between health plan & provider/vendor community.
• Demonstrate strong initiatives in self-learning with independent trouble shooting, identifying issues and solutioning skills.
• Ability to effectively communicate complex findings to both technical and non-technical audiences.
• Ability to work effectively in a team environment and contribute to shared goal.