As a Technical Lead - HEDIS, you will be a part of an Agile team to design and build healthcare applications and implement new features while adhering to the best coding development standards
Responsibilities: -
- QA Lead - HEDIS QA & Audit Readiness test Lead Ensure our HEDIS product produces accurate.
- audit-ready results by validating data ingestion, transformations, measure calculations, and IDSS submission artifacts according to current NCQA specifications and timelines.
- Build Regression and Exploratory test suite Train testers on testing the measures and audit outcomes.
- Validate teams test outcomes on measure outputs Check Dry-run IDSS submissions Exercise quarterly workflows.
- Reproduce end-user scenarios Audit-readiness testing IS Standards & HD Standards coverage Mock audit results Supplemental data, ECDS, and DAV.
Educational Qualifications: -
- Bachelor's or Master's degree in Computer Science, Engineering, or related field.
Skills: -
Mandatory Technical skills
- 4 to 7 years in healthcare quality reporting (HEDIS/Stars/QARR/AMP) or healthcare data QA.
- Experience collaborating with NCQA Licensed Audit Organizations is a plus.
- Hands-on testing of IDSS files and PLD outputs;
- Ability to read and validate NCQA data dictionaries/templates
- Prior work with supplemental data and ECDS reporting (EHR/HIE/registry feeds);
- knowledge of DAV implications for audit use.
- Tooling: XML validators (XSD), FHIR validators, SQL, API test tools;
- Experience building automated checks for HEDIS validations.
Good to have skills: -
- Exposure to NCQA dQMs / Digital Content Services; ability to test FHIR-CQL execution environments.
- Experience with vendor ecosystems (e.g., NCQA-certified measure engines, claim quality platforms) and AMP/QARR programs.
- Participation in HEDIS MRR (medical record review) workflows and abstraction QA.
