HEDIS Data Engineer

Job Title: HEDIS Data Engineer
Location: Remote
Employment Type: Fulltime
Job Description
Senior Data Engineer
HEDIS-Focused Data Engineering
We are looking for a Senior Data Engineer with hands-on HEDIS (Healthcare Effectiveness Data and Information Set) experience. You will design, build, and maintain the pipelines and platforms that power HEDIS measure calculation, quality reporting, and regulatory submissions across the company. This role is for someone who understands the technical and clinical nuances of HEDIS data — supplemental data, hybrid measures, NCQA specifications — and
can translate that into reliable, well-documented data pipelines.
What You'll Do
• Design, build, and maintain scalable batch and streaming data pipelines supporting HEDIS measure calculation and reporting
• Ingest and transform claims, encounter, lab, pharmacy, and supplemental data feeds used in HEDIS measure logic
• Implement and maintain HEDIS measure specifications (NCQA Volume 2) in code, ensuring accurate translation of clinical logic into data transformations
• Support annual HEDIS reporting cycles, including hybrid measure data collection, rate calculation, and submission-ready extracts
• Build automated testing and validation to confirm HEDIS measure outputs match specification and prior-year trends
• Partner with quality/clinical teams, compliance, and analytics to understand measure requirements and NCQA/CMS updates each year
• Investigate and resolve discrepancies in HEDIS rates, source data gaps, and measure logic issues
• Maintain clear documentation of data lineage, transformation logic, and measure mappings for audit and NCQA review purposes
• Continuously improve pipeline architecture for scalability, performance, and data integrity across HEDIS reporting workflows
What We're Looking For
• 5+ years of experience in data engineering or a closely related field, including direct HEDIS experience
• Hands-on experience with HEDIS measure specifications (NCQA Volume 2) and HEDIS reporting cycles
• Familiarity with healthcare data types relevant to HEDIS: claims, encounters, eligibility, pharmacy, lab, and supplemental data
• Strong SQL skills and hands-on experience with at least one major data warehouse (Snowflake, BigQuery, Redshift, or similar)
• Proficiency in Python or Scala/Java for building production data pipelines
• Experience with modern orchestration tools (Airflow, Dagster, Prefect, or similar)
• Solid understanding of data modeling, dimensional design, and ETL/ELT best practices in a healthcare context
• Experience working with or alongside HEDIS/quality measure engines (e.g., Inovalon, Cotiviti, MedInsight, or custom rules engines) is a plus
HEDIS Experience :
We are hiring specifically for someone with hands-on HEDIS (Healthcare Effectiveness Data and Information Set) experience. In this role, you will be expected to:
• Have directly built, maintained, or supported pipelines feeding HEDIS measure calculation or rate reporting
• Understand NCQA HEDIS specification updates and how measure logic changes year over year
• Are comfortable working with hybrid measures, including medical record/supplemental data integration
• Can trace a HEDIS rate back through the pipeline to its source claims/encounter data for audit purposes
• Have worked within HEDIS submission timelines and understand the compliance stakes involved
Nice to Have
• Experience with NCQA HEDIS audits or working alongside a certified HEDIS compliance auditor
• Familiarity with dbt and analytics engineering workflows
• Exposure to Stars ratings, CMS quality measures, or other regulatory quality reporting alongside HEDIS
• Experience operating in a health plan, MCO, or other regulated healthcare data Environment
“Tekshapers is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.”

Work arrangement
No