HEDIS Data Quality Integrity Analyst

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families.

It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds

About the role

The role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out quality analytics. The incumbent for this position will design and implement a structured approach to data quality, ensuring our HEDIS data accurately reflects the health status of our members. The position is a key team member collaborating in a multi-disciplinary business environment with colleagues across the enterprise to lead quality performance analytics, development, and reporting that deliver actionable insights.

As a subject matter expert, the role collects business requirements as per State, CMS, and NCQA specifications, translates business requirements into analytics design, define data & analytics specifications, manipulates and analyze large healthcare data from various data sources, and interpret the findings to inform opportunities and solutions that improve clinical quality and increase cost efficiency and health care affordability.