Healthcare Business Systems Analyst with HEDIS/NCQA Experience

Cygnus Professionals Inc. is seeking a Healthcare Business Systems Analyst to support healthcare data integration, HEDIS/NCQA regulatory reporting, and strategic initiatives using Azure and Databricks. The role analyzes and maps healthcare data, translates business requirements, validates data, and supports testing and collaboration across business and technical teams.

Responsibilities:

• Analyse and map upstream healthcare data, including claims, eligibility, provider, encounter, and supplemental data
• Translate business requirements into functional documents, user stories, and comprehensive source-to-target mappings
• Perform complex SQL-based data analysis using Databricks to validate data accuracy and troubleshoot issues
• Facilitate requirement walkthroughs with business, development, QA, and data engineering teams
• Support User Acceptance Testing (UAT), defect resolution, data quality validations, and reconciliation processes
• Participate in Agile ceremonies, track project dependencies, and ensure full requirement traceability

Requirements:

• Minimum of 5+ years of healthcare IT experience
• a Bachelor's degree in Computer Science, Information Systems, or a related field
• Minimum 3+ years of data management and data lake experience within a healthcare payer organization (Payer/MCO)
• Minimum 3+ years of hands-on experience working with HEDIS or other healthcare quality measurement data
• Strong technical expertise in Azure, Azure Databricks, and executing complex SQL queries
• Experience working with Power BI or Tableau, HL7/FHIR standards, and CMS Interoperability
• Proficiency across core healthcare data domains: Member, Provider, Claims, Authorization, Pharmacy, and Clinical