Business Analyst- US Healthcare(NCS/Job/ 1456)

Role: Business Analyst

Years of experience : 5+ years to 10years

Band : B2 & B3

Location:  Any Wipro Location in India

Notice Period: Immediate joiners

The SDS Business Analyst will be responsible for management of supplemental data sources (SDS), including audit documentation, HEDIS technical specification review, and tracking of supplemental data sources. This role requires collaboration with appropriate areas of the business to ensure the most efficient management of data with the highest level of quality and greatest Enterprise gain. All work supports Commercial, Medicare & Medicaid lines of business. Additionally, this role will support process improvement through the identification of data source opportunities for improvement and development of associated action plans.

Primary Responsibilities:

Source Management

• Knowledgeable of clinical supplemental data sources as used in HEDIS® data processing – purpose, intent of use, data collection method
• Responsible for audit documentation completion and quality of documentation
• Responsible for medical record requests to support medical record review or primary source verification – related to HEDIS® audit
• Knowledgeable of NCQA HEDIS® technical specifications regarding supplemental data and applicable measures
• Responsible for tracking of source documentation readiness

Data Management

• Maintain documentation of end-to-end data flow of sources
• Knowledgeable of data validation reports of sources
• Awareness of data load specifications to HEDIS® rules engines

Audit Management

• Maintain documentation of audit review outcome by source
• Support Quality Solutions Delivery with HEDIS® audit – for all audit groups involved with annual audit  -- address audit issues/concerns within required turnaround time
• Complete work on time, especially as it pertains to HEDIS® audit deadlines

Other Responsibilities:

• Develop & produce ad-hoc reports
• Participate with complex analyses and reports
• Works independently; seeks guidance on only the most complex tasks
• Works collaboratively with other team members, business partner teams, and other technology teams
• Support national projects /pilots

Qualifications:

• 2+ years of experience with HEDIS® documentation and auditing processes
• 3+ years’ experience in Healthcare Industry with clinical data (non-claims), with a focus with understanding of medical terminology and clinical care
• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex information in a manner that others can understand
• A bachelor’s degree

Competencies:

• Experience with writing SQL queries
• IT experience with data collection, processing, analysis, and reporting
• Understanding of data gathering/analysis
• Advanced MS Excel and MS Access skills
• Advance proficiency in MS Office (including Work, Outlook, PowerPoint, Visio)
• Problem solving skills: the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.

FYI below: