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HEDIS Data & Systems Analyst II

HEDIS Data & Systems Analyst II

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Job Description


The HEDIS Data & Systems Analyst II will support corporate, plan-level, and departmental strategies and goals for HEDIS processes and reporting. The Analyst will meet this standard by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems. This position involves managing the HEDIS reporting application, ETL development, system analysis, data analysis, report development, and technical support for HEDIS Quality initiatives. Coordinate and execute the daily support activities to ensure the delivery of technical services and participate in the fulfillment of customer’s requests. Own the responsibilities of planning and developing enhancements to the application by working with vendors as well as applying upgrades, patches, and hot fixes.


  • Provide system administration support to the HEDIS application used for government regulatory reporting; research of software defects, trouble-shooting, and defining solutions for defects
  • Coordinate with the HEDIS software vendor to update software, obtain data files and supporting documentation
  • Monitor the completeness and accuracy of data collected and compiled in the databases
  • Extract, transfer, load, and reconcile large amounts of data across multiple system platforms and sources 
  • Understands the different data sources and their inter-relationships; develops the capability to use multiple sources of information develop extracts and conduct data analysis
  • Process data using certified HEDIS software to provide monthly and annul HEDIS rates
  • Develop and maintain an expert level of knowledge regarding quality reporting requirements from all regulatory bodies
  • Perform verification and UAT testing, including creation of test plans, test scripts and coordination of UAT testing with customers
  • Perform data mining and analysis to identify data cleansing opportunities
  • Work with the Project Manager to generate the HEDIS Roadmap for annual Audits; work with auditors, vendors, and internal staff to prepared for and successfully complete all aspects of the Audit
  • Participates in implementation of performance improvement activities, including HEDIS projects, as assigned;
  • Gather business requirements, assess customer needs, and design solutions to improve business efficiency and productivity
  • Build and deploy ad-hoc reports
  • Adhere to change management policies to minimize the impact of changes.
  • Assist with training and mentoring other departmental Analysts
  • Performs other related duties as assigned.



  • Possess a 4-year college degree in Computer Science, Information Systems, Business Administration, or related field and minimum of 3 years’ experience…or 7 years of equivalent work experience in a Business, Data, or Systems Analyst role.


  • Healthcare experience preferred
  • Knowledge of healthcare data (ex: claims, enrollment, codes, provider demographics)
  • Familiarity with key managed care functions including Claims, Enrollment, Medical Management, and Network Development/Provider Service
  • IT experience, including data warehouse, coding or ETL experience; proficient with PL/SQL or T-SQL
  • Experience with SQL Server Management Studio, SQL Server Integration Services (SSIS), and MS Office applications required
  • Ability to manage various sources of information and large data sets
  • Experience in supporting third party applications and end-users in a corporate environment
  • Project management experience preferred
  • Ability to analyze and improve processes
  • Ability to effectively communicate and build relationships with internal teams and stakeholders
  • Strong team player
  • Must take a proactive approach towards executing on numerous tasks and priorities simultaneously while managing competing priorities
  • Previous experience with certified HEDIS software preferred
  • Excellent oral and written communication skills
  • Excellent analysis and problem-solving skills
  • Ability to document and gather business requirements


  • Physical health sufficient to meet the ergonomic standards and demands of the position.


About Us

Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 


We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  


All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE


Our mission is to inspire healthy living within the communities we serve!

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