Senior Product Engineer - HEDIS SME
About The Position
Huron is seeking a Senior Product Engineer - HEDIS SME to join our HDTx Payer Services team, supporting healthcare payer clients in advancing data quality, regulatory reporting, and analytics capabilities. This role will operate at the intersection of business engagement, product engineering, and healthcare data strategy, with an initial focus on data quality and HEDIS reporting, evolving into predictive analytics and STARs performance optimization. This individual will serve as a subject matter expert and trusted advisor, working closely with payer leadership, business stakeholders, and technical teams to deliver scalable, high-impact solutions.
Requirements
- 7–12+ years of healthcare payer experience, with strong domain expertise in: HEDIS reporting, CMS STARs methodology, Regulatory reporting and quality programs
- Demonstrated experience in data quality management, reporting, and analytics within payer environments.
- Strong understanding of: Claims and encounter data, Data lifecycle, validation, and reconciliation processes
- Proven ability to engage business stakeholders and translate requirements into solutions.
- Experience working in client-facing consulting or product engineering environments.
- Strong communication skills with ability to interface across technical and non-technical teams.
- Applicants must be U.S. Citizens
Responsibilities
- Lead data quality initiatives impacting HEDIS, CMS submissions, and regulatory reporting accuracy.
- Assess, identify, and resolve data gaps, inconsistencies, and lineage issues across payer systems.
- Drive improvements in data validation, reconciliation, and reporting processes to ensure compliance and performance accuracy.
- Partner with stakeholders to define and implement data governance frameworks and standards.
- Serve as SME for HEDIS measures and CMS STARs rating methodologies, ensuring alignment of reporting and performance strategies.
- Translate complex regulatory requirements into functional and technical specifications.
- Support measurement strategy, performance monitoring, and reporting optimization to improve STARs outcomes.
- Provide advisory support to payer clients on CMS data submission and reporting best practices.
- Lead design and optimization of solutions leveraging: Cognizant CMS Edge Server, Claimsphere, Core payer platforms (e.g., Facets).
- Drive integration and data flow across claims, encounter, and reporting systems.
- Collaborate with engineering teams to deliver scalable reporting and analytics products.
- Develop and implement predictive models and analytics frameworks to improve quality outcomes and STARs performance.
- Enable advanced analytics capabilities using payer data to identify trends, risks, and opportunities.
- Evolve reporting solutions into forward-looking, insights-driven platforms.
- Engage directly with business and executive stakeholders, acting as a strategic advisor.
- Translate business needs into technical roadmaps and product solutions.
- Lead or contribute to client-facing discussions, workshops, and design sessions.
- Collaborate across multi-disciplinary teams (data, IT, compliance, business operations).
Benefits
- medical, dental, and vision coverage to employees and dependents
- a 401(k) plan with a generous employer match
- an employee stock purchase plan
- a generous Paid Time Off policy
- paid parental leave and adoption assistance
- Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year.
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What This Job Offers
Career Level
Senior
Education Level
No Education Listed
