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About the job

Location: 1611 NW 12th ave. Miami, FL 33136

Shift: 8:00AM 4:30 PM

Miami, FL Full-Time Ambulatory Services Administrate

*********NEEDS TO HAVE HEDIS technical specifications experience to be considered

Summary

The Quality Data Integrity Analyst is responsible for ensuring the accuracy, completeness, and reliability of all data used for HEDIS and related quality measure reporting. This role performs data validation, interprets technical specifications, monitors measure performance, and identifies care gaps that impact quality outcomes. The analyst collaborates with clinical teams, operational leaders, and payer partners to strengthen data integrity, optimize measure performance, and support compliance with quality standards.

Responsibilities

Perform comprehensive data validation and integrity checks on clinical and administrative data used for HEDIS and related quality measure reporting, ensuring accuracy, completeness, and alignment with technical specifications.

Analyze measure performance, care gap trends, and population - level outcomes to identify opportunities for improvement and risk mitigation.

Interpret and apply HEDIS technical specifications, value sets, and reporting requirements to ensure consistent and compliant data handling across systems and workflows.

Conduct detailed audits, reconciliation activities, and data quality investigations to resolve discrepancies and strengthen measure reliability.

Collaborate with clinical teams, care management, providers, and payer partners to support gap closure strategies and improve measure performance.

Develop visually compelling dashboards, reports, and summaries that translate complex HEDIS data and other quality data into actionable insights for leadership and operational teams.

Monitor organizational performance against national benchmarks, accreditation standards, and payer expectations, highlighting areas of risk, opportunity, and emerging trends.

Contribute to the refinement of documentation practices, data capture workflows, and system processes to enhance clinical performance and overall data integrity.

Provide analytical expertise and recommendations that inform strategic planning, quality priorities, and organizational initiatives aimed at improving patient outcomes and operational excellence.

Performs other related duties as assigned.

Experience

Generally requires 3 to 5 years of related experience.

Education

Bachelor's degree in related field is required.

Skill

Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with critical thinking and professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications.

Credentials

Active license or certification is required as needed, based on the job or specialty.

Unit Specific Credential

Working Conditions

Physical Requirements - Job function is sedentary in nature and requires sitting for extended periods of time. Function may require frequent standing or walking. Must be able to lift or carry objects weighing up to 20 pounds. Jobs in this group are required to have close visual acuity to perform activities such as extended use of computers, preparing and analyzing data and analytics, and other components of a typical office environment. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).

Environmental Conditions - Jobs in this group are required to function in a fast-paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Possible exposure to various environments such as communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May wear Personal Protective Equipment (PPE) such as gloves or a mask when exposed to hospital environment outside of office. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC)