Senior Product Manager / Engineer - HEDIS SME
About The Position
Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Healthcare payer organizations are under immense pressure to improve outcomes and reduce the cost of providing coverage for patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Huron is seeking a Senior Product Engineer / Principal 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
Nice To Haves
- Hands-on experience with: Hedis Reporting SME, Cognizant CMS Edge Server, Claimsphere, Facets (TriZetto) or similar payer platforms
- Experience with predictive analytics / data science applications in healthcare
- Background in risk adjustment, quality improvement, or value-based care programs
- SQL, data modeling, or advanced analytics tool experience
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)
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
