HEDIS Data Quality Program Lead

Blue-Cross-Blue-Shield-Association

Chicago (IL)

Hybrid

USD 113,000 - 153,000

Full time

11 days ago

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Benefits offered by this job

Paid time off

11 holidays

Medical/dental/vision insurance

401(k) matching

Lifestyle spending account

Job summary

Blue-Cross-Blue-Shield-Association seeks a HEDIS Data Quality Specialist to lead data quality strategy, oversee HEDIS portal, and drive performance improvements with cross-functional teams. The role supports HEDIS reporting for NCQA and FEHBP, utilizing SAS, SQL, Cognos, and MCSource for advanced analytics.

The position emphasizes end-to-end testing, data integrity, and effective communication with business partners to optimize data and address defects.

Qualifications

Bachelor's degree or equivalent required.
7+ years in a business environment, managed care, or health services delivery with expertise in health care operations, claims processing, and healthcare informatics.
Strong communication and interpersonal skills; ability to present to audiences internal/external to BCBS A.
Advanced analytic skills for data interpretation and insights.

Responsibilities

Support and execute the HEDIS data quality strategy for optimal HEDIS submission to NCQA.
Oversee HEDIS portal, QCR data profiling, and HEDIS reporting; coordinate with stakeholders.
Develop and monitor quality performance standards for plans and FEHBP; drive year‑round HEDIS data strategy.
Perform data mining and analyses to identify opportunities for performance improvement in HEDIS operations.
Create presentations and content for conferences; support project management and implementation.