Key skills
SQL
About this role
Must Have's:
1.Strong BA skills 2.Knowledge of HEDIS measures / Strong understanding of CQL 3. Proficiency in SQL
Analyze business requirements related to healthcare quality measurement and translating them into clear functional and technical specifications.
Collaborate with client and internal teams to ensure compliance with HEDIS, NCQA and CMS regulations.
Strong knowledge of HEDIS measures, NCQA guidelines, and healthcare quality reporting frameworks.
Hands-on experience with Clinical Quality Language (CQL) reading, mapping, and validation.
Proficiency in SQL for data extraction, transformation, and analysis in support of quality measure reporting.
Support the API lifecycle including design, documentation, testing, and deployment, with a focus on healthcare quality measures.
Participate in requirement workshops, prepare detailed use cases, process flows, and mapping documentation aligned with CQL/HEDIS standards.
Partner with QA teams to define test scenarios and ensure accurate measure calculations.
Provide subject matter expertise on Clinical Quality Language (CQL) logic, measure development, and implementation for HEDIS and other quality programs.
Monitor industry updates on interoperability standards, FHIR, and quality measure specifications to guide continuous improvement.