Hybrid HEDIS Audit Quality Manager NCQA Compliance Lead

Elevance Health; Severn (MD); Hybrid; USD 99,000 - 163,000; Full time

Benefits offered by this job

Hybrid work model

Benefits package

Job summary

Elevance Health seeks a HEDIS Audit Quality Manager to lead all HEDIS audit activities across lines of business and the enterprise, ensuring timely submissions to NCQA, CMS, and state regulators.

You will manage audit processes, allocate resources, and serve as an expert resource to quality committees. The role requires collaboration with health plans and internal teams to drive compliant, data-driven improvements.

Qualifications

• BA/BS in a health care field and at least 3 years healthcare-related experience; plus 3 years in QA/QI.
• Strong knowledge of NCQA HEDIS audit guidelines and submission processes.
• Experience managing HEDIS audit projects across multiple lines of business.

Responsibilities

• Coordinate and oversee all HEDIS submission activities.
• Interface with clients and quality committees to review HEDIS requirements.
• Lead and manage HEDIS audit processes and resources.
• Ensure compliance with NCQA, CMA, and State HEDIS requirements.
• Develop audit work plans with deliverables and timelines.
• Analyze quality data and report to the quality committee.
• Coordinate with health plans on state audits.

Education

BA/BS in health care field

Job description

Elevance Health seeks a HEDIS Audit Quality Manager to lead all HEDIS audit activities across lines of business and the enterprise, ensuring timely submissions to NCQA, CMS, and state regulators.

You will manage audit processes, allocate resources, and serve as an expert resource to quality committees. The role requires collaboration with health plans and internal teams to drive compliant, data-driven improvements.