Job Description

Job Title: Healthcare Business Analyst (HEDIS & STARS)

Location: Louisville, KY (Onsite)

Duration: Long-Term Contract

We are seeking an experienced Healthcare Business Analyst with a strong background in HEDIS and STARS programs to support quality improvement initiatives, data analysis, and performance reporting within the healthcare domain. The ideal candidate will have in-depth knowledge of healthcare quality metrics, data sources, and regulatory requirements for Medicare and Medicaid programs.

• Serve as a liaison between business stakeholders, quality teams, and IT for HEDIS and STARS initiatives.
• Analyze healthcare data to identify trends, gaps, and opportunities for improving quality measures and member outcomes.
• Support the annual HEDIS data collection and validation process, ensuring compliance with NCQA guidelines.
• Assist in Stars program performance analysis , measure tracking, and improvement planning.
• Work closely with business users to gather and document requirements for reporting, dashboards, and process enhancements.
• Collaborate with data teams to ensure accuracy and completeness of healthcare quality data.
• Develop functional specifications and contribute to the testing and validation of HEDIS/Stars analytics solutions.
• Prepare performance reports, presentations, and executive summaries for leadership review.
• Stay current with CMS , NCQA , and other regulatory updates related to quality measurement.

• 5+ years of experience as a Business Analyst in the Healthcare domain.
• Strong knowledge of HEDIS , STARS , NCQA , and CMS quality measures .
• Proficiency in data analysis tools (SQL, Excel, or BI platforms such as Power BI or Tableau).
• Experience working with claims, eligibility, and provider data .
• Understanding of healthcare workflows, quality programs, and risk adjustment models.
• Excellent analytical, documentation, and communication skills.
• Ability to work with cross-functional teams in a fast-paced environment.

• Bachelor's degree in Healthcare Administration , Information Systems , Public Health , or related field.
• Experience with Medicare Advantage or Managed Care organizations.
• Knowledge of ETL processes and data warehousing concepts .
• Familiarity with Agile methodology and tools like JIRA or Confluence .

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