Description
As the HEDIS Quality Program Principal at Waymark, you will own Waymark's approach to contractual quality performance, including HEDIS and partner-specific quality measures.
You will own the end-to-end operationalization of quality measures and campaigns,from understanding the measure and identifying the opportunity, to designing and deploying high-impact programs, developing workflows, job aids and enablement, coordinating implementation, monitoring execution, and evaluating performance.
Key Responsibilities:
- Own the portfolio of HEDIS contractual quality measures and roadmap across Waymark's partnerships.
- Translate measure specifications and partner requirements into executable programs, including building workflows and scoping and directly managing vendor partners.
- Conduct retrospectives, root cause analyses, and structured improvement cycles to identify execution friction points and accelerate gap closure.
- Collaborate with Care Operations and Learning and Development teams to develop and maintain the job aids, SOPs, training, and enablement needed for care teams to execute campaigns consistently.
- Coordinate supplemental data submissions and reconciliation across payer partners.
- Partner with the Analytics team to define measure logic, dashboards, patient lists, gap reporting, and automated monitoring.
- Serve as a Subject Matter Expert for the Clinical Product Development team to ensure the ideation and requirements for new automation and AI innovations reflect best practices.
- Serve as a Subject Matter Expert for the Business Development team on HEDIS metrics and targets during contract negotiations.
- Stay informed about industry trends and best practices in quality and clinical management and integrate into our operations and product design.
Minimum Qualifications:
- 7+ years of experience in healthcare quality, quality operations, population health, value-based care, managed care, or a related field.
- 5+ years experience with NCQA HEDIS quality measures and performance programs.
- Experience with BI and reporting tools such as Looker, Tableau, Power BI, or equivalent platforms.
- Strong program and project management skills with a proven ability to lead complex, cross-functional initiatives.
Preferred Qualifications:
- Experience with Medicaid managed care.
- Lean Six Sigma or related quality improvement certification.
- Graduate or Advanced Degree (MPH, MHA, MBA).
The expected hiring range for this role is $127,000 – $157,000, depending on relevant experience, skills, and qualifications.
Benefits include stock options, work-from-home stipend, incentive program, medical, vision, and dental coverage, life insurance, paid time off, parental leave, retirement savings, commuter benefits, and professional development stipend.