HEDIS Data Quality Strategist & Program Lead

001_BCBSA Blue Cross and Blue Shield Association; Washington, Chicago (District of Columbia, IL); Hybrid; USD 113,000 - 153,000; Full time

Benefits offered by this job

Annual bonus incentive pay

Paid time off

11 holidays

Medical/dental/vision insurance

Generous 401(k) matching

Lifestyle spending account

Job summary

Blue Cross Blue Shield Association (BCBSA) oversees HEDIS data quality and reporting strategies to optimize NCQA submissions. The role coordinates cross-functional teams, supports QA testing, and drives data improvements across plans and vendors.

The candidate will analyze data to enhance HEDIS operations, develop methodologies, and prepare content for stakeholder presentations and conferences. A Bachelor's degree and 7+ years in healthcare operations are required.

Qualifications

• Bachelor's degree or equivalent experience is required.
• 7+ years in a business environment with managed care/health services experience.
• Strong communication and interpersonal skills across audiences.
• Advanced analytic skills with the ability to analyze and interpret data.
• Knowledge of HEDIS data, HEDIS measures, and healthcare informatics is preferred.

Responsibilities

• Develop, communicate, and monitor quality performance standards for plans and FEPI; focus on HEDIS data strategy and reporting.
• Support end-to-end testing for compliance and efficiency improvements; liaise with partners to optimize data and resolve defects.
• Create and deliver presentations, reports, and materials; support project management and conferences for accurate system and process execution.
• Develop accurate HEDIS processes and maintain relationships with Quality departments; resolve complex data issues and document methodologies.

Skills

Excellent communication

Advanced analytic skills

Data mining

Curiosity and determination

Healthcare operations knowledge

Education

Bachelor's degree

Tools

SAS

SQL

Cognos

MCSource

Job description

Blue Cross Blue Shield Association (BCBSA) oversees HEDIS data quality and reporting strategies to optimize NCQA submissions. The role coordinates cross-functional teams, supports QA testing, and drives data improvements across plans and vendors.

The candidate will analyze data to enhance HEDIS operations, develop methodologies, and prepare content for stakeholder presentations and conferences. A Bachelor's degree and 7+ years in healthcare operations are required.