Senior HEDIS & Clinical Quality Program Lead (Hybrid)

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

Job summary

Blue Shield of CA is seeking a Senior Program Manager to lead the planning and execution of annual HEDIS audit operations within the Clinical Quality Analytics team. You will serve as the primary operational liaison to external HEDIS audit firms and drive timely completion of roadmaps, requests, onsite activities, and cross-functional deliverables.

We look for leaders who empower teams, apply critical thinking, and foster continuous learning.

Qualifications

• Bachelor's degree or equivalent; four additional years of relevant experience in lieu of degree.
• 5+ years of program or project management experience with ownership of cross‑functional deliverables and risk management.
• Strong understanding of project/resource management and enterprise tools.
• Excellent written and verbal communication; ability to influence without authority.
• Experience with HEDIS reporting and NCQA HEDIS compliance audits; liaison to external HEDIS audit firms preferred.

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.

Skills

Project management

Stakeholder comms

Analytical thinking

Problem solving

Communication skills

Cross-functional leadership

HEDIS audits

Vendor liaison

PMP preferred

Education

Bachelor's degree

High school diploma/ GED + 4 years experience

Job description

Blue Shield of CA is seeking a Senior Program Manager to lead the planning and execution of annual HEDIS audit operations within the Clinical Quality Analytics team. You will serve as the primary operational liaison to external HEDIS audit firms and drive timely completion of roadmaps, requests, onsite activities, and cross-functional deliverables.

We look for leaders who empower teams, apply critical thinking, and foster continuous learning.