HEDIS Data Quality Strategy Lead | Hybrid Program Manager

Blue Cross Blue Shield Association; Washington; Hybrid; USD 113,000 - 153,000; Full time

Benefits offered by this job

Paid time off

11 holidays

Medical/dental/vision insurance

401(k) matching

Job summary

Blue Cross Blue Shield Association is seeking a health quality data professional to lead HEDIS data quality strategies and ensure optimal NCQA submissions. You will oversee the HEDIS portal, perform QCR data profiling, and collaborate across plans and vendors to improve data quality and reporting accuracy.

The role emphasizes advanced analytics, data mining, and cross-functional communication to drive performance improvements in HEDIS operations.

Qualifications

• 7+ years in a business environment, focus in health care operations, claims processing, and healthcare informatics.
• Experience with HEDIS data quality and NCQA submissions.
• Strong communication, analytical, and data interpretation skills.

Responsibilities

• Develop, communicate, and monitor quality performance standards for plans and FEPM.
• Support end-to-end testing for compliance and efficiency.
• Create and deliver presentations, reports, and summaries for stakeholders.
• Resolve complex data issues and maintain data integrity across systems.

Skills

Communication

Analytics

SAS

SQL

Cognos

MCSource

Education

Bachelor’s degree

AHIP - Professional

MHP – Managed Healthcare Professional

Tools

SAS

SQL

Cognos

MCSource

Job description

Blue Cross Blue Shield Association is seeking a health quality data professional to lead HEDIS data quality strategies and ensure optimal NCQA submissions. You will oversee the HEDIS portal, perform QCR data profiling, and collaborate across plans and vendors to improve data quality and reporting accuracy.

The role emphasizes advanced analytics, data mining, and cross-functional communication to drive performance improvements in HEDIS operations.