Hybrid HEDIS Program Manager - Clinical Quality Analytics

Blue Shield of CA; Lodi (CA); Hybrid; USD 140,000 - 190,000; Full time

Job summary

Blue Shield of CA is seeking a Senior Program Manager to oversee annual HEDIS audit operations and coordination with external audit firms. The role reports to the Director of Clinical Quality Analytics and focuses on timely roadmaps, requests, onsite activities, and cross-functional deliverables.

We value leaders who foster high-performing teams, critical thinking, and continuous learning. This is a hybrid role with in-office collaboration two days per week, balancing in-person work with

Qualifications

• Bachelor's degree or high school diploma/GED with four additional years of relevant experience in lieu of a degree.
• 5+ years of program or project management experience with cross-functional deliverables and risk management.
• Understanding of project/resource management and enterprise tools.
• Strong analytical, problem-solving, organizational and communication skills.
• Experience with HEDIS reporting and NCQA audits, liaison to external firms preferred.
• Experience coordinating virtual HEDIS onsite audits and data exchanges preferred.
• Knowledge of health plan clinical quality operations and audit documentation practices preferred.
• PMP or related certification preferred; not required.

Responsibilities

• Lead planning and execution of annual HEDIS audit operations.
• Serve as primary operational liaison to external HEDIS audit firms.
• Drive timely completion of audit roadmaps, information requests, onsite activities, and cross-functional deliverables.
• Collaborate with health plan teams to support compliance and reporting needs.

Skills

Analytical skills

Communication skills

Cross-functional collaboration

Stakeholder management

Independent action

Education

Bachelor's degree

PMP or related certification preferred

Job description

Blue Shield of CA is seeking a Senior Program Manager to oversee annual HEDIS audit operations and coordination with external audit firms. The role reports to the Director of Clinical Quality Analytics and focuses on timely roadmaps, requests, onsite activities, and cross-functional deliverables.

We value leaders who foster high-performing teams, critical thinking, and continuous learning. This is a hybrid role with in-office collaboration two days per week, balancing in-person work with