National Quality Performance Manager- HEDIS / SQL

Jobgether SRL

United States

Remote

USD 60,000 - 130,000

Full time

8 days ago
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Benefits offered by this job

Fully remote
Competitive compensation
Remote-first company culture

Job summary

Jobgether SRL seeks a National Quality Performance Manager focused on HEDIS and SQL to lead national healthcare quality initiatives. Remote work across the United States is offered, with cross-functional collaboration to improve data-driven quality performance.

You will drive analytics, reporting, and regulatory readiness, shaping care-gap closure and quality outcomes. The role requires strong stakeholder management, data skills, and experience with HEDIS/CAHPS in a matrixed healthcare

Qualifications

  • 3+ years in healthcare quality program or project management.
  • Experience with HEDIS, NCQA, CAHPS, CMS, and state-specific quality submissions preferred.
  • Strong data analysis, reporting, and problem-solving skills.
  • Ability to translate complex concepts to diverse stakeholders.
  • Experience in matrixed organizations, managed care environments preferred.

Responsibilities

  • Collaborate with health plan quality leaders to develop data collection analytics and reporting for HEDIS and CAHPS.
  • Monitor quality programs from initiation to delivery, ensuring milestones and timelines.
  • Oversee data ingestion and validation for EHR, HIE, and supplemental data.
  • Analyze quality performance data to identify trends and opportunities for improvement.
  • Support regulatory and audit readiness by managing roadmaps and timelines.
  • Provide proactive status reporting to stakeholders.
  • Build strong relationships with internal and external stakeholders.
  • Contribute to enterprise-wide quality improvement initiatives.

Skills

Program management
Healthcare analytics
SQL querying
Stakeholder management
Data interpretation

Education

PMP certification
Six Sigma Green Belt/Black Belt

Tools

SQL Server
Microsoft Azure
Excel

Job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a National Quality Performance Manager- HEDIS / SQL based in United States.

This role provides subject matter expertise across national healthcare quality performance initiatives, with a strong focus on HEDIS, CAHPS, and SQL.

You will collaborate with health plan leaders and cross-functional teams to turn complex quality data into actionable performance improvements.

The position spans quality analytics, data validation, regulatory readiness, reporting, forecasting, and care-gap identification.

You will help strengthen data completeness and accuracy across EHR, HIE, claims, and supplemental data sources.

The role offers broad visibility across a highly collaborative, matrixed healthcare environment and requires strong stakeholder engagement.

You will monitor strategic quality programs from planning through delivery while identifying risks, opportunities, and areas for improvement.

This is a fully remote opportunity for a data-driven quality professional who can combine analytical expertise with effective program management.

Accountabilities
  • Collaborate with health plan quality leaders to develop and manage quality data collection strategies, analytics, and reporting covering HEDIS performance, quality-rate trending and forecasting, provider performance, CAHPS and survey analytics, health equity, SDOH, and external vendor activities.

  • Monitor quality-related programs and projects from initiation through successful delivery, ensuring milestones, resources, deliverables, and timelines remain aligned with strategic objectives.

  • Oversee quality data ingestion and validation activities, identify data issues, document findings, and improve the completeness and accuracy of EHR, HIE, and supplemental data.

  • Analyze quality performance data to identify trends, risks, care gaps, and opportunities for measurable improvement.

  • Support compliance with quality-related regulatory and audit requirements by managing deliverable roadmaps and timelines and implementing solutions that strengthen HEDIS audit readiness and performance.

  • Partner with cross-functional teams to maintain data quality across sequential transformations and identify opportunities to close quality-of-care gaps.

  • Create, review, and maintain quality program documentation, including project plans, reports, records, analyses, and supporting materials.

  • Provide clear and proactive status reporting to stakeholders, communicating progress, risks, issues, dependencies, and recommended actions.

  • Build effective relationships with internal and external stakeholders, establish trust, understand customer expectations, and ensure quality initiatives meet business and operational requirements.

  • Support enterprise-wide quality performance improvement initiatives through data-driven insights and coordinated execution.

Requirements
  • At least 3 years of program or project management experience within healthcare quality, or an equivalent combination of relevant education and professional experience.

  • Healthcare industry experience or demonstrated functional knowledge of healthcare quality programs.

  • Strong knowledge or practical experience related to HEDIS, NCQA, CAHPS, CMS, and state-specific quality or regulatory submission requirements is preferred.

  • Experience with SQL or the ability to run queries using Microsoft Azure or SQL Server is preferred.

  • Strong proficiency in data analysis, manipulation, interpretation, reporting, and quantitative problem-solving.

  • Ability to translate complex technical or quality concepts into clear, actionable information for diverse stakeholders.

  • Strong critical-thinking, analytical, problem-solving, organizational, and attention-to-detail skills.

  • Knowledge of healthcare data and coding elements such as CPT, CPT II, LOINC, SNOMED, HCPCS, NDC, CVX, NPI, and TIN is preferred.

  • Experience working in a highly matrixed organization, preferably within managed care environments supporting Medicaid, Medicare, and/or Marketplace programs.

  • Strong verbal, written, presentation, and stakeholder-management skills.

  • Proficiency with Microsoft Office, including Excel, and the ability to quickly learn and navigate new technology and software platforms.

  • Ability to collaborate effectively across departments, manage multiple priorities, and maintain progress across complex initiatives.

  • PMP certification is preferred.

  • Six Sigma Green Belt, Black Belt, or comparable coursework is preferred.

Benefits
  • Annual salary range of $59,810.60--$129,589.63, with actual compensation varying based on geographic location, professional experience, education, and skill level.

  • Full-time, fully remote position within the United States.

  • Opportunity to work on national healthcare quality performance initiatives involving HEDIS, CAHPS, SQL, analytics, and regulatory quality programs.

  • Cross-functional exposure to health plan quality, data, analytics, regulatory, and operational teams.

  • Opportunity to contribute directly to quality improvement, care-gap closure, data accuracy, and healthcare outcomes.

  • Competitive compensation and benefits package.

  • Equal employment opportunity workplace.

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