Principal, HEDIS Quality Programs

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $127k - $157k / year

⏰ Full Time

🔴 Lead

👻 Ghost score 4%

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Waymark

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2018

📣 Marketing

🤖 Artificial Intelligence

Marketing • Artificial Intelligence • Advertising

Waymark is a creative technology company that leverages artificial intelligence to revolutionize ad production. Their platform enables users to create high-impact, agency-quality video ads quickly and effortlessly, without requiring prior experience. By personalizing ads with a brand's unique content and utilizing AI-driven creativity, Waymark allows businesses to unlock new revenue streams and enhance their marketing strategies. With their cutting-edge tools, users can produce custom-tailored ads in minutes, significantly reducing the cost and time of traditional ad production.

📋 Description

• Own Waymark’s portfolio of HEDIS contractual quality measures and roadmap across partnerships. • Translate measure specifications and partner requirements into executable programs, workflows, and scalable operational infrastructure. • Scope and directly manage vendor partners for last-mile gap closure, including home lab visits and at-home diagnostic kit distribution. • Conduct retrospectives, root cause analyses, and structured improvement cycles to accelerate gap closure. • Collaborate with Care Operations and Learning and Development teams on job aids, SOPs, training, and enablement. • Coordinate supplemental data submissions and reconciliation across payer partners. • Partner with Analytics to define measure logic, dashboards, patient lists, gap reporting, and automated monitoring; validate outputs and troubleshoot discrepancies. • Advise Clinical Product Development as a subject matter expert on HEDIS best practices, automation, and AI innovations. • Advise Business Development on HEDIS metrics and targets during contract negotiations. • Monitor industry trends and best practices in quality and clinical management and integrate them into operations and product design. • Report to the Vice President of Care Operations.

🎯 Requirements

• 7+ years of experience in healthcare quality, quality operations, population health, value-based care, managed care, or a related field. • 5+ years experience with NCQA HEDIS quality measures and performance programs, including translating requirements into implementable, scalable programs and operational workflows. • Experience with BI and reporting tools such as Looker, Tableau, Power BI, or equivalent platforms. • Strong program and project management skills with a proven ability to lead complex, cross-functional initiatives and manage competing priorities in a fast-paced environment. • Comfort and demonstrated success driving program execution independently with a bias for action. • Proven track record of managing operational vendors or clinical partners to deliver home-based services, diagnostic programs, or field campaigns. • Excellent written and verbal communication skills, including presentation skills, for engaging with executive leadership, training frontline staff, and building strong partnerships with cross-functional teams and external stakeholders. • Demonstrated ability to identify and manage quality program risks, develop mitigation strategies, and foster a culture of continuous improvement. • Experience designing member outreach campaigns, care-team workflows, tasking, job aids, or training in support of quality measures. • Ability to manage large volumes of data, analyze data, identify data gaps and develop reporting for performance management. • Must be able to work in a matrix environment. • Bachelor’s degree. • Employment is contingent upon successful completion of a background check. • Medicaid managed care experience preferred. • Lean Six Sigma or related quality improvement certification preferred. • Graduate or Advanced Degree (MPH, MHA, MBA) preferred.

🏖️ Benefits

• Stock Options: Opportunity to invest in the company’s growth. • Work-from-Home Stipend: A dedicated stipend for your first year to help set up your home office. • Incentive Program: Receive additional compensation through performance-based incentives that align with organizational goals and enhance patient outcomes. • Medical, Vision, and Dental Coverage: Comprehensive plans to keep you and your family healthy. • Life Insurance: Basic life insurance to give you peace of mind. • Paid Time Off: 20 vacation days, accrued over the year, plus 11 paid holidays. • Parental Leave: 16 weeks of paid leave for birthing parents after six months of employment, and 8 weeks of bonding leave for non-birthing parents. • Retirement Savings: Access to a 401(k) plan with a company contribution, subject to a vesting schedule. • Commuter Benefits: Convenient options to support your commute needs. • Professional Development Stipend: A dedicated stipend supports professional development and growth.