BSA, Lead (HEDIS)

Lead Business Systems Analyst - HEDIS (Healthcare Payer)
Location: Hybrid (Newark NJ) - 2 consecutive days onsite per month

NOTE: We are not able to consider third party candidates. Third parties should not contact us about this position.

Position Overview
We are seeking a Lead Business Systems Analyst (BSA) with deep Healthcare Payer experience to support strategic HEDIS and Quality Management initiatives. This individual will serve as the primary liaison between Quality Management (QM) business stakeholders and technology teams, leading requirements definition, Agile delivery activities, and cross-functional collaboration.
The ideal candidate combines strong business analysis skills with the ability to analyze healthcare data, profile large datasets, and translate complex business needs into well-defined Agile requirements. This role requires someone who is comfortable working across both business and technical teams while driving successful delivery of HEDIS-related initiatives.


Primary Responsibilities

• Serve as the primary liaison between Quality Management (QM) business stakeholders and technical delivery teams.
• Lead requirements gathering sessions with business users to understand HEDIS reporting, quality measurement, and operational needs.
• Translate business requirements into detailed Agile artifacts including user stories, acceptance criteria, epics, and features.
• Partner closely with Product Owners, Scrum Masters, Architects, Developers, QA, and Data Engineering teams throughout the software development lifecycle.
• Facilitate backlog refinement, sprint planning, requirement walkthroughs, and other Agile ceremonies.
• Analyze complex healthcare data to validate business requirements and support solution design.
• Profile and evaluate data from multiple enterprise data sources including Databricks, Hadoop, and other clinical and healthcare data platforms.
• Write and execute SQL queries to analyze data, validate business logic, troubleshoot issues, and support testing activities.
• Collaborate with technical teams to ensure business requirements are accurately implemented and delivered.
• Support User Acceptance Testing (UAT) by validating business functionality and ensuring solutions meet Quality Management objectives.
• Identify process improvement opportunities and recommend solutions that improve quality reporting and operational efficiency.
• Communicate effectively with both executive business stakeholders and technical delivery teams.

Required Qualifications

• 7+ years of Business Systems Analysis experience.
• Recent Healthcare Payer industry experience is required.
• Experience supporting HEDIS, Quality Management, Quality Improvement, or related healthcare quality initiatives.
• Strong experience serving as the liaison between business stakeholders and technical development teams.
• Extensive experience working within Agile software development environments.
• Proven ability to create user stories, acceptance criteria, process flows, and functional requirements using Agile methodologies.
• Advanced SQL skills with the ability to independently analyze, validate, and profile data.
• Experience working with large enterprise healthcare datasets.
• Strong analytical and problem-solving skills.
• Excellent communication, facilitation, and stakeholder management abilities.

Preferred Qualifications

• Experience supporting HEDIS reporting and quality measurement initiatives.
• Experience with healthcare clinical data and quality reporting platforms.
• Familiarity with enterprise data warehousing concepts.
• Experience working with healthcare data integration and analytics platforms.
• Knowledge of healthcare quality measures, regulatory reporting, and payer operations.
• Experience working with cross-functional enterprise technology organizations.

Technical Skills

• SQL (Advanced)
• Data Profiling
• Healthcare Data Analysis
• Agile (Scrum/Kanban)
• User Stories
• Acceptance Criteria
• Requirements Elicitation
• Backlog Management
• Azure DevOps, Jira, or similar Agile management tools