Senior Business Analyst- Health Care (HEDIS)

HMG America LLC is the best Business Solutions focused Information Technology Company with IT consulting and services, software and web development, staff augmentation and other professional services. One of our direct clients is looking for Senior Business Analyst- Health Care (HEDIS) in Philadelphia, PA. Below is the detailed job description.

• Lead requirements end to end, independently driving discovery, analysis, and solution definition across business and IT stakeholders.
• Serve as a subject matter expert on HL7 exchange protocols, including FHIR, CCDs, ADTs, etc.
• Perform hands on data analysis using SQL, Databricks, and related tools to validate data, troubleshoot issues, and support design decisions.
• Prior Experience on `HEDIS and Quality process and HEDIS Data is a plus
• Document business and technical requirements, source to target mappings, data specifications, business rules, and process flows.
• Support validation and QA by reviewing data outputs, test cases, and results to ensure accuracy and compliance.
• Collaborate with internal teams and external partners with minimal supervision to gather requirements, drive key decisions, and support successful implementations.
• Mentor and guide junior BAs on best practices in requirements, documentation, analysis, and stakeholder engagement.
• Communicate business and process solutions, recommendations, and issues to client management on a regular basis.
• Document all business process flows related to interoperability initiatives.
• Apply working knowledge of internal customer Managed Care functions (HealthCare Services, Claims, Enrollment, Quality/HEDIS, Risk Adjustment, Care Management, Utilization Management) to support problem solving and solution design.