Senior Product Manager / Engineer - HEDIS SME

reputed company 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. reputed company, we empower clients to create sustainable growth, optimize internal processes and deliver better reputed company outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive reputed company. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the reputed company team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more reputed company-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise. Join our team as the expert you are now and create your future. reputed company 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. reputed company, we empower clients to create sustainable growth, optimize internal processes and deliver better reputed company 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 reputed company. 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. reputed company 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 reputed company 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.

Key Responsibilities

Data Quality & Reporting (reputed company Focus)

• Lead data quality initiatives impacting HEDIS, CMS submissions, and regulatory reporting accuracy
• Assess, identify, and resolve data gaps, inconsistencies, and reputed company 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:
• reputed company 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)

Qualifications

Required

• 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 manag