Sr Program Manager - HEDIS Initiatives

This position reports to the Director, Medicare Stars & Quality Performance, and with matrix’ed dotted line reporting to the Director of Medicaid & Commercial Quality Performance. This position will lead initiatives focused on driving HEDIS performance improvement across all JHHP lines of business.

The HEDIS Initiatives Program Manager will be familiar with value-based models, Star Ratings, HEDIS®, NCQA Health Plan Rating measures and best practice quality improvement strategies. The HEDIS Initiatives Program Manager will lead the planning and execution of cross-entity activities and committees, working with departmental leadership throughout JHHP to optimize HEDIS scores in support of achieving each LOB’s quality performance objectives. This role will also partner with data/analytics team(s) to guide priorities and requirements for optimized HEDIS reporting and self-service dashboard capabilities, and analyze data to identify strategies and priorities for focused improvement work.

This position will be focused on quality performance goals through project management, data analytics, and stakeholder collaboration.

With support of the Director of Medicare Stars & Quality Performance, the HEDIS Initiatives Program Manager will be responsible for staying up-to-date and educating JHHP leadership and staff regarding upcoming NCQA proposed programmatic and measure-level changes and identifying strategic opportunities for readiness.

This role requires hands-on expertise in managing programs and projects focused on quality management, data analytics, workflow optimization, and clinical process improvement. The position functions in a matrixed environment, requiring collaboration across the JHHP organization.

Requirements:

Education:

Bachelor’s degree in health administration, nursing or other clinical health profession, clinical data analytics, business administration, or a related field required; Master’s degree preferred.

Work Experience:

5 years health care/ managed care experience required. Training in the Principles of Quality Management and Improvement, NCQA and HEDIS experience preferred.
5 year of experience facilitating projects required; experience working with multiple clinical and operational functional units and their leadership is highly preferred.
3 years of experience working in population health or quality improvement preferred.