Supervisor Quality Performance

Blue Cross and Blue Shield of Kansas•Topeka, IN

6d•Hybrid

About The Position

The Supervisor of Quality Performance is responsible for leading a high-performing team in the end-to-end abstraction of healthcare data, including prospective, retrospective, and supplemental collection. This role ensures adherence to quality and productivity standards while managing timelines and deliverables for HEDIS operations and audits. The Supervisor drives continuous improvement in abstraction workflows through data validation, process optimization, and staff development. This position is eligible to work remotely, hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.

Requirements

Proven expertise in HEDIS measures, abstraction methodologies, and NCQA audit protocols.
Demonstrated success in managing quality improvement projects and abstraction operations.
Strong leadership, communication, and organizational skills.
Advanced working knowledge of HEDIS technical specifications and regulatory reporting.
Bachelor’s degree in health care administration, Business Administration, Public Health, Nursing, or a related field.
In lieu of degree: Minimum 3 years of experience with HEDIS®, Star measures, or regulatory quality reporting
Minimum 3 years of direct HEDIS®/Star abstraction or chart review experience.
Minimum of 3 years of healthcare or quality management experience, including 2 years of project management.
Minimum of 2 years’ experience in a supervisory or lead role.
Experience with Medicare Star Ratings and quality performance reporting.

Nice To Haves

Certified Professional in Healthcare Quality (CPHQ) or related credential preferred.

Responsibilities

Accountable for performance monitoring, policy enforcement, termination process, disciplinary action, hiring, compliance and team development.
Maintaining accurate records of all hiring, firing and disciplinary actions.
Supervise abstraction staff, assign responsibilities, and ensure quality and productivity standards are met.
Manage project timelines and deliverables for HEDIS operations and audits, ensuring alignment with regulatory deadlines.
Drive improvements in abstraction workflow, accuracy, and efficiency through data validation, process refinement, and staff training.
Oversee the year-round primary source verification (PSV) process to ensure completeness and integrity of supplemental data.
Collaborate with internal departments (e.g., IT, Health Plan Quality, Compliance) and external partners to coordinate data requests, audit submissions, and chart retrieval efforts.
Maintain current knowledge of HEDIS technical specifications, NCQA audit requirements, and CMS Medicare Star metrics.
Support audit readiness and respond to auditor inquiries and data validation requests.
Monitor team performance and provide coaching, training, and professional development.
Contribute to the development and implementation of policies, procedures, and performance metrics for the quality operations team.
Analyze, track, and trend abstraction.