Health Plan Operations Program Manager - HEDIS Initiatives

Johns Hopkins Medicine; Northern (KY); Hybrid; USD 62,000 - 99,000; Full time

Job summary

Johns Hopkins Medicine is seeking an experienced HEDIS Initiatives Program Manager to lead quality performance improvement across JHHP lines, leveraging data analytics and collaborative governance.

You will plan and execute cross-entity committees, translate NCQA proposed changes into readiness plans, and work with leadership to optimize HEDIS reporting and dashboards.

Qualifications

• Bachelor’s degree in health administration, nursing or other clinical health profession, clinical data analytics, business administration, or a related field required; Master’s degree preferred.
• 5 years health care/ managed care experience required. Training in the Principles of Quality Management and Improvement, NCQA and HEDIS experience preferred.
• 5 year of experience facilitating projects required; experience working with multiple clinical and operational functional units and their leadership is highly preferred.
• 3 years of experience working in population health or quality improvement preferred.

Responsibilities

• Lead initiatives focused on driving HEDIS performance improvement across all JHHP lines.
• Plan and execute cross-entity activities and committees, working with departmental leadership to optimize HEDIS scores.
• Partner with data/analytics teams to guide priorities for optimized HEDIS reporting and self-service dashboards.
• Analyze data to identify strategies and priorities for focused improvement work.
• Stay current on NCQA proposed programmatic and measure-level changes and educate JHHP leadership accordingly.

Skills

Project management

Data analytics

Stakeholder collaboration

Education

Bachelor's degree

Master's degree

Job description

This position reports to the Director, Medicare Stars & Quality Performance, and with matrix’ed dotted line reporting to the Director of Medicaid & Commercial Quality Performance. This position will lead initiatives focused on driving HEDIS performance improvement across all JHHP lines of business.

The HEDIS Initiatives Program Manager will be familiar with value-based models, Star Ratings, HEDIS®, NCQA Health Plan Rating measures and best practice quality improvement strategies. The HEDIS Initiatives Program Manager will lead the planning and execution of cross-entity activities and committees, working with departmental leadership throughout JHHP to optimize HEDIS scores in support of achieving each LOB’s quality performance objectives. This role will also partner with data/analytics team(s) to guide priorities and requirements for optimized HEDIS reporting and self-service dashboard capabilities, and analyze data to identify strategies and priorities for focused improvement work.

This position will be focused on quality performance goals through project management, data analytics, and stakeholder collaboration.

With support of the Director of Medicare Stars & Quality Performance, the HEDIS Initiatives Program Manager will be responsible for staying up-to-date and educating JHHP leadership and staff regarding upcoming NCQA proposed programmatic and measure-level changes and identifying strategic opportunities for readiness.

This role requires hands-on expertise in managing programs and projects focused on quality management, data analytics, workflow optimization, and clinical process improvement. The position functions in a matrixed environment, requiring collaboration across the JHHP organization.

Requirements

Education

Bachelor’s degree in health administration, nursing or other clinical health profession, clinical data analytics, business administration, or a related field required; Master’s degree preferred.

Work Experience

• 5 years health care/ managed care experience required. Training in the Principles of Quality Management and Improvement, NCQA and HEDIS experience preferred.
• 5 year of experience facilitating projects required; experience working with multiple clinical and operational functional units and their leadership is highly preferred.
• 3 years of experience working in population health or quality improvement preferred.

Salary Range

Salary Range: Minimum 44.81/hour - Maximum 71.70/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.