HEDIS Quality and Audit Analyst
Core
Supports enterprise HEDIS quality oversight, audit readiness, and submission execution for NCQA audits and CMS submissions.
Role type
HEDIS Quality and Audit Analyst
Builds
NCQA audit deliverables and CMS submission packages
Domain
Healthcare quality measurement and regulatory compliance
Deliverable
dashboards & analysis
Required skills
HEDIS standards knowledge, audit preparation, documentation management, timeline management, population validation, CMS submission coordination, quality assurance
Preferred skills
Healthcare environment experience, process improvement
Responsibilities
Perform NCQA HEDIS audit activities including Roadmap and Section 5 documentation preparation; Manage audit and submission timelines and dependencies; Collaborate on reporting population validation and measure selection; Oversee CMS submission activities and PLD coordination; Identify and escalate audit issues and documentation gaps; Lead audit meetings and internal stakeholder reviews; Perform quality checks on audit materials.
Seniority
Mid-level, hands-on IC