[Remote] Senior Technical Program Manager
Note: The job is a remote job and is open to candidates in USA. NLB Services is seeking a Senior Technical Program Manager with hands-on HEDIS experience to lead annual HEDIS reporting programs. The role manages cross-functional planning and execution across data engineering, clinical/quality, compliance, analytics, and vendors through NCQA submission, while ensuring regulatory deadlines, audit readiness, risk management, and process improvements.
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 Technical 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