Remote HEDIS Data Architect & Quality Analytics Lead

Talanto; Chicago, Northern (IL, KY); Hybrid; USD 83,000 - 96,000; Full time

Benefits offered by this job

Medical coverage for employees and, if

Dental coverage

Vision coverage

401(k) plan with generous match

Employee stock purchase plan

Paid time off

Job summary

Talanto in the United States is seeking a HEDIS Data Analyst | Architect to join our HDTx Payer Services practice on a remote, contract basis. You will support HEDIS measurement, reporting, validation, and CMS program activities within a health plan environment.

The role requires 4–6+ years in healthcare payer analytics, strong SQL, data architecture awareness, and the ability to translate complex data findings into actionable business insights for stakeholders.

Qualifications

• 4-6+ years of healthcare payer, health plan, or managed care experience.
• Experience supporting solution design, architecture documentation, or data platform modernization.
• Exposure to healthcare data architecture concepts, including source-to-target mapping, data lineage, integration design, reporting architecture, and scalable data model design.
• Strong hands-on HEDIS knowledge for reporting initiatives.
• Experience working within a Health Plan, Managed Care Organization, Medicare Advantage, Medicaid, or Commercial payer environment.
• Understanding of CMS regulations, CMS STAR Ratings, quality programs, and regulatory reporting requirements.
• Advanced SQL experience for healthcare data analysis and validation.
• Strong communication and presentation skills.

Responsibilities

• Support HEDIS measurement, reporting, validation, and annual submission activities.
• Interpret HEDIS measure specifications and translate business requirements into data and reporting solutions.
• Analyze HEDIS performance results and identify opportunities to improve quality scores and close care gaps.
• Contribute to HEDIS solution architecture activities, including data flow design, integration approach, reporting architecture, and scalable data model recommendations.
• Partner with technical architects and engineering teams to align HEDIS reporting requirements with platform capabilities, data governance standards, and long‑term architecture decisions.
• Partner with quality, population health, provider engagement, and care management teams to support HEDIS initiatives.
• Assist with HEDIS audits, documentation reviews, and quality assurance activities.
• Gather, analyze, document, and validate business requirements from health plan stakeholders.
• Perform root cause analysis on data quality issues impacting HEDIS, CMS reporting, and operational performance.
• Develop source‑to‑target mappings, business rules, process flows, and functional specifications.
• Analyze large healthcare datasets and present findings, trends, and recommendations to business stakeholders.
• Support UAT testing, reconciliation, defect resolution, and deployment validation activities.
• Analyze claims, encounters, eligibility, provider, pharmacy, and supplemental data used for HEDIS and CMS reporting.
• Validate data completeness, accuracy, reconciliation results, and reporting outputs.
• Support CMS quality initiatives, STAR Ratings programs, and regulatory reporting requirements.
• Collaborate with business and technical teams to improve reporting processes and data governance practices.
• Understand payer operational workflows including claims processing, provider data, membership, enrollment, and quality management programs.
• Facilitate requirements sessions, stakeholder interviews, and process reviews.
• Translate technical findings into business recommendations and executive‑level communications.
• Support delivery of strategic payer transformation and data modernization initiatives.

Skills

SQL

Healthcare data analysis

HEDIS knowledge

Communication skills

Problem solving

Education

Bachelor's degree in Healthcare Administration, Information Systems, Business, Data Analytics, Public Health, or related field

Job description

Talanto in the United States is seeking a HEDIS Data Analyst | Architect to join our HDTx Payer Services practice on a remote, contract basis. You will support HEDIS measurement, reporting, validation, and CMS program activities within a health plan environment.

The role requires 4–6+ years in healthcare payer analytics, strong SQL, data architecture awareness, and the ability to translate complex data findings into actionable business insights for stakeholders.