[Remote] HEDIS Technical Program Manager

Note: The job is a remote job and is open to candidates in USA. Tekshapers is seeking a Senior Technical Program Manager to lead annual HEDIS reporting programs. The role oversees complex cross-functional initiatives spanning data engineering, clinical and quality teams, compliance, and vendors from planning through NCQA submission, while managing deadlines, risks, audit readiness, and leadership communication.

Responsibilities

• Lead end-to-end planning and execution of the annual HEDIS reporting program, from measure specification updates through NCQA submission
• Build and manage program timelines around fixed HEDIS/NCQA deadlines, including hybrid measure medical record review windows
• Partner with data engineering, clinical/quality teams, compliance, and vendors (e.g., HEDIS certified software vendors, medical record retrieval vendors) to coordinate deliverables
• Track measure-by-measure progress across the HEDIS reporting cycle and escalate risks to leadership early
• Coordinate with compliance and quality teams on NCQA audit readiness and HEDIS compliance auditor requirements
• Drive postmortems after each reporting cycle and turn lessons learned into process improvements for the next year
• Own program-level reporting and status communication to leadership on HEDIS rate progress, data readiness, and submission risk
• Facilitate trade-off discussions when timelines are at risk, ensuring decisions account for NCQA compliance requirements
• Coordinate dependencies across data engineering, analytics, and clinical teams to keep HEDIS measure data flowing on schedule
• Have directly led or supported a HEDIS reporting program through at least one full annual cycle
• Understand the interplay between NCQA specification updates, data engineering timelines, and hybrid measure collection
• Are familiar with NCQA HEDIS audit requirements and working alongside a certified HEDIS compliance auditor
• Can coordinate across clinical, compliance, and data teams to resolve measure data issues under deadline pressure
• Have experience managing vendor relationships tied to HEDIS reporting (medical record retrieval, HEDIS software, etc.)

Skills

• • 5+ years of experience as a Program Manager or similar role, including direct experience managing HEDIS reporting programs
• • Working knowledge of HEDIS measure specifications (NCQA Volume 2) and the annual HEDIS reporting timeline
• • Familiarity with hybrid measure processes, including medical record review and supplemental data collection
• • Strong technical background sufficient to engage credibly with data engineers on pipeline and measure logic issues
• • Proven track record of delivering complex, multi-team programs on time against fixed regulatory deadlines
• • Excellent stakeholder management and communication skills across engineering, clinical/quality, compliance, and executive audiences
• • Comfortable with program management tooling (Jira, Asana, Smartsheet, or similar) and building reporting that surfaces real signal
• • Have directly led or supported a HEDIS reporting program through at least one full annual cycle
• • Understand the interplay between NCQA specification updates, data engineering timelines, and hybrid measure collection
• • Are familiar with NCQA HEDIS audit requirements and working alongside a certified HEDIS compliance auditor
• • Can coordinate across clinical, compliance, and data teams to resolve measure data issues under deadline pressure
• • Have experience managing vendor relationships tied to HEDIS reporting (medical record retrieval, HEDIS software, etc.)
• • Experience with CMS Stars ratings or other regulatory quality reporting programs alongside HEDIS
• • Background in health plan operations, quality improvement, or clinical data prior to moving into program management
• • Experience introducing or scaling HEDIS reporting process improvements at a growing health plan or vendor
• • PMP, Agile, or Scrum certification

Company Overview

Company H1B Sponsorship