Director, HEDIS Performance & Strategy (Enterprise Medicare) - REMOTE
About The Position
The Director, HEDIS Performance & Strategy leads the execution of enterprise initiatives to improve HEDIS measures aligned with Medicare Star Ratings. As a strategic partner to senior quality leadership, this role translates priorities into coordinated workstreams across markets and shared services, aligning operations, supplemental data, reporting, provider engagement, and quality improvement. The ideal candidate brings deep expertise in HEDIS operations, Medicare Stars, supplemental data, and measure implementation, with the ability to analyze performance, influence matrixed stakeholders, and drive accountability.
Requirements
- Deep expertise in HEDIS specifications, Medicare Star Ratings, supplemental data, and enterprise quality operations.
- Demonstrated success leading complex, cross-functional Medicare quality initiatives and operational workstreams in matrixed organizations.
- Strong analytical skills with experience interpreting performance data and operational impacts.
- Excellent relationship management and communication skills.
Nice To Haves
- Lean Six Sigma Black Belt preferred certification.
- DSNP experience preferred.
Responsibilities
- Lead enterprise execution of Medicare HEDIS and Stars strategies by translating quality priorities into actionable measure-level workstreams.
- Coordinate enterprise readiness planning for upcoming NCQA, CMS, HEDIS, and Stars measure changes.
- Drive implementation of operational, documentation, coding, workflow, and supplemental data enhancements aligned to measure requirements.
- Align Quality, Care Management, Pharmacy, Network, Provider Engagement, Analytics, IT, Supplemental Data, and market stakeholders around enterprise priorities, execution, and accountability.
- Analyze measure gaps, performance trends, supplemental data impact, chase outcomes, and intervention effectiveness to prioritize improvement opportunities.
- Proactively identify performance risks and operational barriers, recommend remediation, and monitor improvement initiatives for Stars-aligned measures.
- Assess opportunities for evaluation, integration, mapping, validation, and optimization of supplemental data sources in partnership with Systems and technical teams.
- Ensure documentation workflows and source systems support data integrity, audit readiness, measure capture, and HEDIS reporting accuracy.
- Maintain enterprise workplans, timelines, risks, dependencies, decisions, and progress reporting while driving stakeholder accountability and continuous improvement.
- Develop executive materials, performance analyses, prioritization recommendations, and implementation updates for leadership and governance forums.
Benefits
- competitive benefits and compensation package
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What This Job Offers
Job Type
Full-time
Career Level
Director
Education Level
No Education Listed
