HEDIS Quality Programs, Principal

Waymark

2h•$127,000 - $157,000•Remote

About The Position

Waymark is seeking a HEDIS Quality Program Principal to own the company’s approach to contractual quality performance, including HEDIS and partner-specific measures. The role leads the end-to-end operationalization of quality measures and campaigns: interpreting measures and identifying opportunities, designing and deploying programs, developing workflows and enablement, coordinating implementation, monitoring execution, and evaluating performance. Reporting to the Vice President of Care Ops, the Principal will help build and scale a critical component of Waymark’s care model to improve patient outcomes and contractual performance. The role works across Care Operations, Learning and Development, Analytics, Clinical Product Development, Business Development, payer partners, and external vendors. It also incorporates industry quality and clinical-management practices into operational processes and product design.

Requirements

At least 7 years of experience in healthcare quality, quality operations, population health, value-based care, managed care, or a related field.
At least 5 years of 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 the ability to lead complex cross-functional initiatives and manage competing priorities in a fast-paced environment.
Demonstrated ability to drive program execution independently with a bias for action.
Track record managing operational vendors or clinical partners delivering home-based services, diagnostic programs, or field campaigns.
Excellent written, verbal, and presentation communication skills for engaging executive leadership, training frontline staff, and partnering with cross-functional teams and external stakeholders.
Ability to identify and manage quality program risks, develop mitigation strategies, and foster 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 performance-management reporting.
Ability to work in a matrix environment.
Bachelor’s degree.

Nice To Haves

Experience with Medicaid managed care.
Lean Six Sigma or related quality improvement certification.
Graduate or advanced degree such as an MPH, MHA, or MBA.

Responsibilities

Own the portfolio and roadmap of HEDIS contractual quality measures across Waymark’s partnerships.
Translate measure specifications and partner requirements into executable programs, workflows, and scalable operational infrastructure.
Scope and directly manage vendor partners, including vendors supporting last-mile gap closure such as home lab visits and at-home diagnostic kit distribution.
Conduct retrospectives, root cause analyses, and structured improvement cycles to identify execution friction and accelerate gap closure.
Collaborate with Care Operations and Learning and Development to develop and maintain job aids, SOPs, training, and enablement for care teams.
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 so automation and AI innovations reflect best practices, reduce manual work, and support scalable, efficient HEDIS programs.
Advise Business Development on HEDIS metrics and targets during contract negotiations.
Stay informed about quality and clinical-management trends and best practices and integrate them into operations and product design.

Benefits

Stock options.
Work-from-home stipend for the first year.
Performance-based incentive program.
Medical, vision, and dental coverage.
Basic life insurance.
20 vacation days accrued over the year and 11 paid holidays.
Paid parental leave: 16 weeks for birthing parents after six months of employment and 8 weeks of bonding leave for non-birthing parents.
401(k) plan with a company contribution, subject to a vesting schedule.
Commuter benefits.
Professional development stipend.