Job Description
Business Analyst:
Key Responsibilities:
- Analyze and interpret Star Ratings and HEDIS metrics to identify performance gaps and improvement opportunities.
- Collaborate with clinical, operational, and IT teams to develop and implement strategies that enhance quality scores.
- Translate business needs into technical requirements, workflows, and reporting specifications.
- Develop dashboards and reports using tools like SQL, Power BI, Tableau, or similar platforms.
- Monitor regulatory updates from CMS, NCQA, and other governing bodies to ensure compliance.
- Support data validation, quality audits, and performance improvement initiatives.
- Document business processes and recommend enhancements to optimize outcomes.
- Assist in preparing presentations and reports for leadership and external stakeholders.
Qualifications:
- Bachelor’s degree in healthcare administration, Business, Information Systems, or related field.
- 3+ years of experience in healthcare analytics, quality improvement, or business analysis.
- Strong understanding of HEDIS measures, Medicare Star Ratings, and quality reporting frameworks.
- Proficiency in SQL, Excel, and data visualization tools.
- Excellent communication and stakeholder management skills.
- Experience with claims data, EHR systems, and risk adjustment models is a plus.
Preferred Skills:
- Familiarity with CAHPS, PQA, and other quality programs.
- Experience working with health plans, provider groups, or managed care organizations.
- Knowledge of data governance, ETL processes, and healthcare regulatory standards.
Experience: 5-8 Years .
Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Of yourself, your career, and your skills. We want to see the constant evolution of our business and our industry. It has always been in our DNA - as the world around us changes, so do we. Join a business powered by purpose and a place that empowers you to design your own reinvention.