HEDIS Tech & Data Platform Lead

Sentara Health Plans; Norfolk, Northern (VA, KY); Hybrid; USD 117,000 - 217,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Tuition assistance

401k/403B with employer match

Job summary

Sentara Health Plans seeks an IT HEDIS Manager to lead technology, data integration, and platform operations for the HEDIS program. You will manage ETL developers and production staff, coordinating with IT, Quality, vendors, audits, and project stakeholders to support data feeds, validation, and reporting.

The role supports a major engine replacement initiative, migrating from Inovalon/Cotiviti to a future-state platform with Arcadia involvement, ensuring NCQA-related functionality and data

Qualifications

• Seven or more years in healthcare data, payer technology, analytics, data warehousing, quality measurement, HEDIS operations, or related IT functions.
• Three or more years of leadership experience managing ETL, data engineering, technical operations, analytics, production support, or similar teams, including direct oversight of staff.
• Experience supporting HEDIS data processing, reporting, validation, audits, quality-measurement platforms, or HEDIS engine implementation, replacement, migration, or parallel-validation activities.
• Strong knowledge of payer enrollment, claims, encounters, pharmacy, provider, laboratory, clinical, supplemental data, ETL, SQL, data warehouses, Databricks, file-based integrations, APIs, testing, reconciliation, and production support.
• Experience working with HEDIS-related vendors or platforms such as Arcadia, Cotiviti, Inovalon, or comparable systems, with the ability to communicate technical issues clearly to business, vendor, audit, project, and executive stakeholders.

Responsibilities

• Lead the IT functions for the HEDIS program, including technology, data integration, platform operations, and technical validation.
• Manage ETL developers and operational support staff while partnering with HEDIS, Quality, business, vendor, audit, and project stakeholders.
• Oversee HEDIS data feeds, production operations, platform support, data-quality controls, technical documentation, vendor coordination, audit support, and reporting deliverables.
• Support the major HEDIS engine replacement initiative, including migration to a future-state platform with Arcadia involvement.
• Coordinate with vendors and audits across IT, Quality and business to ensure compliant, timely deliverables.

Skills

HEDIS data knowledge

Leadership

ETL

Education

Bachelor's degree in IT/CS/Data Management/Healthcare Administration

Tools

Arcadia

Cotiviti

Inovalon

Databricks

SQL

Job description

Sentara Health Plans seeks an IT HEDIS Manager to lead technology, data integration, and platform operations for the HEDIS program. You will manage ETL developers and production staff, coordinating with IT, Quality, vendors, audits, and project stakeholders to support data feeds, validation, and reporting.

The role supports a major engine replacement initiative, migrating from Inovalon/Cotiviti to a future-state platform with Arcadia involvement, ensuring NCQA-related functionality and data