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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in HEDIS measure specifications, including numerator, denominator, and exclusion logic development, while effectively collaborating with technical teams to translate complex specifications into actionable logic. Proficient in analyzing adjudicated paid claims data and supporting value-based care initiatives within a Tableau analytics environment.
Highest-signal resume keywords
HEDIS Measure SpecificationsAdjudicated Paid Claims DataValue-Based Care MetricsTableau Analytics EnvironmentEpic Clarity
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Numerator Logic DevelopmentDenominator Logic DevelopmentExclusion Logic DevelopmentECQM Measure SetsPQA Measure SetsData Quality AnalysisMeasure ValidationSpecification InterpretationPopulation Health AnalyticsQuality Measure Frameworks
Soft Skills
Analytical SkillsCommunication Skills
Tools & Technologies
TableauEpic ClarityCaboodle
Industry Keywords
HEDISValue-Based CareNCQAACOMedicare Advantage StarsMSSPPopulation HealthQuality Analytics
Tech Stack
Tools & technologiesTableau
About the role
Key responsibilities & impact- Review HEDIS, eCQM, and PQA measure specifications to develop and validate numerator, denominator, and exclusion logic
- Support the developer team with the build-out of HEDIS and HEDIS-like quality measures within a Tableau analytics platform
- Work with Epic Clarity/Caboodle data and adjudicated paid claims data to support measure development and validation
- Identify and resolve logic gaps, specification ambiguities, and data quality issues across measure sets
- Validate measure outputs against specification requirements to ensure accuracy and compliance
- Collaborate with analytics, clinical, and technical stakeholders to align measure logic with operational and reporting needs
- Support ongoing measure maintenance, updates, and expansion as the platform scales
- Interpret HEDIS and HEDIS-like quality measure specifications and translate them into clear, accurate logic for developers
Requirements
What you’ll need- Hands-on experience with HEDIS measure specifications including numerator, denominator, and exclusion logic development
- Experience working with adjudicated paid claims data from payers — required
- Strong understanding of value-based care metrics, population health analytics, and quality measure frameworks
- Experience with eCQM and PQA measure sets
- Ability to translate complex measure specifications into clear, actionable logic for a technical developer team
- Strong analytical and communication skills across clinical, operational, and technical audiences
- Must be eligible to work in the U.S. without sponsorship
- Epic Clarity or Caboodle experience preferred
- Experience working within or supporting a Tableau analytics environment preferred
- Background supporting VBC programs such as ACO, Medicare Advantage Stars, or MSSP preferred
- Familiarity with NCQA HEDIS technical specifications and value sets (VSAC) preferred
- Experience in a consulting or advisory capacity supporting population health or quality analytics initiatives preferred
Benefits
Comp & perks- Health insurance
- Dental insurance
- Vision insurance
- 401(k)
- Great culture/working environment