HEDIS Technical Program Manager
Location: Remote
Duration : Long Term
Job Description
We are looking for a Senior Technical Program Manager with HEDIS (Healthcare Effectiveness Data and Information Set) experience to lead our annual HEDIS reporting programs. You will lead complex, cross-functional technical programs — spanning data engineering, clinical/quality teams, and compliance — from planning through NCQA submission, and you will be the person who keeps the HEDIS reporting cycle on track against fixed regulatory deadlines.
What You'll Do
• Lead end-to-end planning and execution of the annual HEDIS reporting program, from measure specification updates through NCQA submission
• Build and manage program timelines around fixed HEDIS/NCQA deadlines, including hybrid measure medical record review windows
• Partner with data engineering, clinical/quality teams, compliance, and vendors (e.g., HEDIS certified software vendors, medical record retrieval vendors) to coordinate deliverables
• Track measure-by-measure progress across the HEDIS reporting cycle and escalate risks to leadership early
• Coordinate with compliance and quality teams on NCQA audit readiness and HEDIS compliance auditor requirements
• Drive postmortems after each reporting cycle and turn lessons learned into process improvements for the next year
• Own program-level reporting and status communication to leadership on HEDIS rate progress, data readiness, and submission risk
• Facilitate trade-off discussions when timelines are at risk, ensuring decisions account for NCQA compliance requirements
• Coordinate dependencies across data engineering, analytics, and clinical teams to keep HEDIS measure data flowing on schedule
What We're Looking For
• 5+ years of experience as a Program Manager or similar role, including direct experience managing HEDIS reporting programs
• Working knowledge of HEDIS measure specifications (NCQA Volume 2) and the annual HEDIS reporting timeline
• Familiarity with hybrid measure processes, including medical record review and supplemental data collection
• Strong technical background sufficient to engage credibly with data engineers on pipeline and measure logic issues
• Proven track record of delivering complex, multi-team programs on time against fixed regulatory deadlines
• Excellent stakeholder management and communication skills across engineering, clinical/quality, compliance, and executive audiences
• Comfortable with program management tooling (Jira, Asana, Smartsheet, or similar) and building reporting that surfaces real signal
HEDIS Experience
Hands-on HEDIS (Healthcare Effectiveness Data and Information Set) experience. In this role, you will be expected to:
• Have directly led or supported a HEDIS reporting program through at least one full annual cycle
• Understand the interplay between NCQA specification updates, data engineering timelines, and hybrid measure collection
• Are familiar with NCQA HEDIS audit requirements and working alongside a certified HEDIS compliance auditor
• Can coordinate across clinical, compliance, and data teams to resolve measure data issues under deadline pressure
• Have experience managing vendor relationships tied to HEDIS reporting (medical record retrieval, HEDIS software, etc.)
Nice to Have
• Experience with CMS Stars ratings or other regulatory quality reporting programs alongside HEDIS
• Background in health plan operations, quality improvement, or clinical data prior to moving into program management
• Experience introducing or scaling HEDIS reporting process improvements at a growing health plan or vendor
• PMP, Agile, or Scrum certification
“Tekshapers is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.”
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