This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a National Quality Performance Manager- HEDIS / SQL based in United States. This role provides subject matter expertise across national healthcare quality performance initiatives, with a strong focus on HEDIS, CAHPS, and SQL. You will collaborate with health plan leaders and cross-functional teams to turn complex quality data into actionable performance improvements. The position spans quality analytics, data validation, regulatory readiness, reporting, forecasting, and care-gap identification. You will help strengthen data completeness and accuracy across EHR, HIE, claims, and supplemental data sources. The role offers broad visibility across a highly collaborative, matrixed healthcare environment and requires strong stakeholder engagement. You will monitor strategic quality programs from planning through delivery while identifying risks, opportunities, and areas for improvement. This is a fully remote opportunity for a data-driven quality professional who can combine analytical expertise with effective program management. Accountabilities - Collaborate with health plan quality leaders to develop and manage quality data collection strategies, analytics, and reporting covering HEDIS performance, quality-rate trending and forecasting, provider performance, CAHPS and survey analytics, health equity, SDOH, and external vendor activities. - Monitor quality-related programs and projects from initiation through successful delivery, ensuring milestones, resources, deliverables, and timelines remain aligned with strategic objectives. - Oversee quality data ingestion and validation activities, identify data issues, document findings, and improve the completeness and accuracy of EHR, HIE, and supplemental data. - Analyze quality performance data to identify trends, risks, care gaps, and opportunities for measurable improvement.
- Support compliance with quality-related regulatory and audit requirements by managing deliverable roadmaps and timelines and implementing solutions that strengthen HEDIS audit readiness and performance. - Partner with cross-functional teams to maintain data quality across sequential transformations and identify opportunities to close quality-of-care gaps. - Create, review, and maintain quality program documentation, including project plans, reports, records, analyses, and supporting materials. - Provide clear and proactive status reporting to stakeholders, communicating progress, risks, issues, dependencies, and recommended actions. - Build effective relationships with internal and external stakeholders, establish trust, understand customer expectations, and ensure quality initiatives meet business and operational requirements. - Support enterprise-wide quality performance improvement initiatives through data-driven insights and coordinated execution. Requirements - At least 3 years of program or project management experience within healthcare quality, or an equivalent combination of relevant education and professional experience. - Healthcare industry experience or demonstrated functional knowledge of healthcare quality programs. - Strong knowledge or practical experience related to HEDIS, NCQA, CAHPS, CMS, and state-specific quality or regulatory submission requirements is preferred. - Experience with SQL or the ability to run queries using Microsoft Azure or SQL Server is preferred. - Strong proficiency in data analysis, manipulation, interpretation, reporting, and quantitative problem-solving. - Ability to translate complex technical or quality concepts into clear, actionable information for diverse stakeholders. - Strong critical-thinking, analytical, problem-solving, organizational, and attention-to-detail skills.
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