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Director Hedis Analyst Jobs (NOW HIRING)

Aegis Medical Group

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HEDIS Coordinator

Leesburg, FL · On-site

$16.50 - $20/hr

... without direct patient contact. Responsibilities * Collect and analyze healthcare quality data from various sources * Monitor compliance with HEDIS measures and regulatory requirements * Audit ...

Aegis Medical Group

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HEDIS Coordinator

Leesburg, FL · On-site

$16.50 - $20/hr

... without direct patient contact. Responsibilities * Collect and analyze healthcare quality data from various sources * Monitor compliance with HEDIS measures and regulatory requirements * Audit ...

Aegis Medical Group

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HEDIS Coordinator

Mount Dora, FL · On-site

$16.50 - $20/hr

... without direct patient contact. Responsibilities * Collect and analyze healthcare quality data from various sources * Monitor compliance with HEDIS measures and regulatory requirements * Audit ...

Aegis Medical Group

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HEDIS Coordinator

Mount Dora, FL · On-site

$16.50 - $20/hr

... without direct patient contact. Responsibilities * Collect and analyze healthcare quality data from various sources * Monitor compliance with HEDIS measures and regulatory requirements * Audit ...

Lumeris, Inc.

Principal Quality Analytics Lead

... direct experience in Medicare Advantage Stars, HEDIS, quality measures, and health plan performance analytics. * Hands-on experience writing complex SQL and extracting data from large, multi-layered ...

Regal Medical Group, Inc.

$24 - $25/hr

The Coordinator has excellent reading comprehension skills in order to analyze and process the ... The Coordinator should behave in a professional manner when interfacing with Medical Directors ...

UHS

Director - Performance Improvement

Reno, NV · On-site

The Director will have direct oversight of the HEDIS Program Manager and ensure that the HEDIS ... Ability to understand, present and analyze data. * Healthcare project management experience ...

UHS

Director - Performance Improvement

Reno, NV · On-site

$90K - $131K/yr

The Director will have direct oversight of the HEDIS Program Manager and ensure that the HEDIS ... Ability to understand, present and analyze data. * Healthcare project management experience ...

UHS

Director - Performance Improvement

Reno, NV · On-site

The Director will have direct oversight of the HEDIS Program Manager and ensure that the HEDIS ... Ability to understand, present and analyze data. * Healthcare project management experience ...

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Director Hedis Analyst information

What are Director HEDIS Analysts?

Director HEDIS Analysts are senior professionals responsible for overseeing the Healthcare Effectiveness Data and Information Set (HEDIS) programs within healthcare organizations. They manage teams that collect, analyze, and report quality performance data to ensure compliance with regulatory standards and improve patient care. Their role often includes developing strategies to enhance HEDIS measure outcomes, collaborating with clinical and IT departments, and ensuring accurate data submission to accrediting bodies. Directors also stay updated on changing HEDIS requirements and work to implement best practices throughout their organization.

What are the key skills and qualifications needed to thrive as a Director HEDIS Analyst, and why are they important?

To thrive as a Director HEDIS Analyst, you need expertise in healthcare data analysis, quality measurement, and a strong understanding of HEDIS metrics, often supported by a degree in health informatics, public health, or a related field. Experience with analytic tools such as SAS, SQL, and healthcare data platforms, along with knowledge of NCQA regulations and HEDIS reporting systems, is crucial. Outstanding leadership, problem-solving, and communication skills help drive quality initiatives and manage cross-functional teams. These skills are essential to ensure accurate reporting, regulatory compliance, and continuous improvement of healthcare quality outcomes.

What is the difference between Director Hedis Analyst vs Hedis Analyst?

AspectDirector Hedis AnalystHedis Analyst
Required CredentialsBachelor's degree, possibly advanced certifications in healthcare or analyticsBachelor's degree in healthcare, statistics, or related field
Work EnvironmentLeadership role overseeing teams, strategic planningData analysis, reporting, and compliance tasks
Employer & Industry UsageHealthcare organizations, insurance companiesHealthcare providers, insurance companies, analytics firms
Common Search & ComparisonHigher-level responsibilities, management focusData-focused, operational role

The main difference between a Director Hedis Analyst and a Hedis Analyst lies in their level of responsibility. The Director Hedis Analyst typically oversees teams and strategic initiatives, requiring leadership skills and possibly advanced certifications. In contrast, the Hedis Analyst focuses on data analysis and compliance tasks. Both roles are vital in healthcare analytics but differ in scope and seniority.

How does a Director HEDIS Analyst typically collaborate with clinical and IT teams to improve data quality and reporting?

A Director HEDIS Analyst often serves as a bridge between clinical, IT, and quality improvement teams to ensure accurate and timely data collection and reporting for HEDIS measures. They coordinate with IT to optimize data extraction from electronic health records, and work closely with clinicians to clarify documentation requirements and address data gaps. Regular meetings, cross-functional training sessions, and collaborative problem-solving are common, fostering a team environment focused on continuous improvement in data quality and compliance.
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Director Hedis Analyst jobs near you
Infographic showing various Director Hedis Analyst job openings in the United States as of June 2026, with employment types broken down into 94% Full Time, and 6% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution.
Senior HEDIS Analyst/ Technical Lead - Denver Health Medical Plan (Must Live in Colorado. Weekly ...

Senior HEDIS Analyst/ Technical Lead - Denver Health Medical Plan (Must Live in Colorado. Weekly ...

Denver Health

Denver, CO • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago

Denver Health rating

7.9

Company rating: 7.9 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

149th of 999 rated hospitals

Job description

We are recruiting for a mission-driven Senior HEDIS Analyst/ Technical Lead - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team!
We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.
Our Values
Respect | Belonging | Accountability | Transparency
Department
Managed Care Administration
* Must Live in Colorado
*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 2 days per week.
Job Summary
This position serves as the technical owner of Healthcare Effectiveness Data and Information Set (HEDIS) outputs from the HEDIS Engine, ensuring accuracy, completeness, and audit readiness of all measure results and working with the HEDIS Clinical Lead to interpret new measure specifications.
The HEDIS Technical Lead is responsible for end-to-end execution of HEDIS measurement, validation, and submission, with a primary focus on HEDIS Engine (Cotiviti) production, rate validation, and NCQA IDSS submission for Denver Health Medical Plan (DHMP). The ideal candidate has hands-on experience running HEDIS cycles in Cotiviti (or similar vendor platforms), validating measure outputs, and managing IDSS submissions, and can partner effectively with data warehouse and clinical team. This role ensures that all HEDIS data is accurate, complete, traceable, and audit-ready.
Essential Functions:
  • HEDIS Technical Execution
    • Serves as Technical Lead on HEDIS Production and Submission Lifecycle
    • Partners with Clinical Lead for strategy development of HEDIS Program
    • Manages test, early production, and production run sequencing
    • Oversees ingestion of claims, encounters, enrollment, provider, and SDS data
    • Ensures data integrity, traceability, and documentation of data flows within the HEDIS Engine
    • Works directly with HEDIS Engine staff to ensure issues are resolved timely
    (40%)
  • Supplemental Data Sources (SDS)
    • Partner with Clinical Lead and internal IT Teams for technical implementation of new and existing SDS
    • Partners with business/clinical stakeholders to translate requirements into technical design
    • Supports mapping, validation, PSV preparation, and remediation
    • Troubleshoots SDS-related issues during runs and audit (20%)
  • QA / UAT (Technical)
    • Owns technical QA/UAT for:
    o Measure output validation and variance analysis
    o CAHPS sample generation and technical files
    • Confirms technical outputs align with HEDIS specifications and business expectations (10%)
  • Submissions & File Management
    • Owns technical aspects of submissions, including:
    o Cotiviti output files
    o Attest uploads
    o NCQA IDSS technical files (XML/CSV)
    o State submissions, as applicable
    • Ensures submissions are complete, timely, and compliant (20%)
  • Audit & Issue Resolution
    • Provides technical evidence and analysis for audit requests
    • Performs root cause analysis for discrepancies or findings
    • Maintains technical documentation to support audit defense and continuity
    (10%)

Education:
  • Bachelor's degree in data analytics, information systems, computer science, or related field required

Work Experience:
  • 4-6 years experience in health care data analytics,with at least 3 years focused specifically on HEDIS-specific technical experience in a health plan or similar environment required
  • 1-3 years experience supporting data validation, QA/UAT, and/or audits required
  • 1-3 years ability to communicate technical concepts to non-technical stakeholders and collaborate effectively across departments required
  • 1-3 years strong SQL and data analysis skills required

Licenses:
Knowledge, Skills and Abilities:
  • Strong knowledge of NCQA HEDIS specifications, CMS Star Ratings, and regulatory reporting to State and Federal programs.
  • Direct experience with HEDIS software tools (e.g., Inovalon QSI-XL, Cotiviti, OnPoint, or other vendors).
  • In-depth knowledge of HEDIS lifecycle, including NCQA IDSS submission formats and requirements.
  • Familiarity with data from clinical systems (e.g., EMR/EHR), claims, encounters, and supplemental data sources.
  • Experience supporting HEDIS audits and PSV processes.
  • Excellent problem-solving, communication, multi-disciplinary collaboration and project management skills.
  • Proficiency in Microsoft Office (Excel, PowerPoint, Word).
  • Accuracy and attention to detail in data analysis and reporting.
  • Proven ability to meet deadlines and manage deliverables.
  • Ability to work independently and manage multiple competing priorities in a fast-paced environment.
  • Experience working with Medicaid, Exchange, Medicare Advantage, or Dual Eligible populations, preferred
  • Knowledge of risk adjustment, care gaps, or other quality-related initiatives such as CAHPS or Health Outcomes Survey (HOS), preferred
  • Advanced proficiency with SQL (Oracle, SQL Server, or similar), with experience writing complex queries and optimizing data pipelines, preferred
  • Experience using reporting and data visualization tools (e.g., Tableau, Power BI, SAS, R, Python), preferred

* Must Live in Colorado
*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 2 days per week.
Shift
Days (United States of America)
Work Type
Regular
Salary
$91,000.00 - $141,000.00 / yr
Benefits
At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future - with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development - while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you're joining a mission-driven organization that invests in you.
Here is a small list of our benefit programs:
  • Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
  • 100% paid parental leave up to 6 weeks
  • Immediate eligibility for retirement plans with employer contribution up to 9.5%
  • Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
  • Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
  • Free RTD EcoPass (public transportation)
  • Childcare discount programs & exclusive perks on large brands, travel, and more
  • Tuition reimbursement & assistance
  • Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
  • Professional clinical advancement program & shared governance
  • Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
  • National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.
As Colorado's primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.

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