Remote HEDIS Quality Programs Principal

OpenKrill; United States; Remote; USD 127,000 - 157,000; Full time

Benefits offered by this job

Stock options

Work-from-home stipend

Incentive program

Medical, Vision, and Dental coverage

Life insurance

Paid time off

Parental leave

401(k) with company contribution

Commuter benefits

Professional development stipend

Job summary

Waymark is seeking a HEDIS Quality Program Principal to own contractual quality measures, including HEDIS, across partnerships. You’ll design and operationalize campaigns, develop workflows, and coordinate enablement for care teams, reporting to the VP of Care Ops.

In this role you’ll translate measure specifications into scalable programs, manage vendor partners, and collaborate with Analytics to define logic and dashboards.

Qualifications

• 7+ years of experience in healthcare quality or related field.
• 5+ years with NCQA HEDIS measures and performance programs.
• Experience with BI tools such as Looker, Tableau, Power BI.
• Strong program and project management in cross-functional initiatives.
• Independent program execution with bias for action.
• Experience managing vendors for home-based services/diagnostics.
• Excellent written and verbal communication, including executive presentations.
• Identify and manage quality program risks; continuous improvement.
• Experience designing member outreach campaigns and workflows.
• Ability to manage large data volumes and reporting.

Responsibilities

• Own the portfolio of HEDIS contractual quality measures and roadmap.
• Translate measure specs into executable programs and manage vendor partners.
• Conduct retrospectives and root cause analyses.
• Collaborate with Care Ops and L&D to develop job aids and SOPs.
• Coordinate supplemental data submissions across payer partners.
• Define measure logic, dashboards, patient lists, gap reporting; validate outputs.
• Serve as SME for Clinical Product Development to reflect best practices and AI innovations.
• Serve as SME for Business Development on HEDIS metrics during contract negotiations.
• Stay informed about industry trends and best practices and integrate into operations.

Skills

Quality operations

Population health

Value-based care

Program management

Vendor management

Communication skills

Data analysis

Education

Bachelor's degree

MPH

MHA

MBA

Lean Six Sigma certification

Tools

Looker

Tableau

Power BI

Job description

Waymark is seeking a HEDIS Quality Program Principal to own contractual quality measures, including HEDIS, across partnerships. You’ll design and operationalize campaigns, develop workflows, and coordinate enablement for care teams, reporting to the VP of Care Ops.

In this role you’ll translate measure specifications into scalable programs, manage vendor partners, and collaborate with Analytics to define logic and dashboards.