Director, HEDIS Standards – Strategic Enablement

DirectorDirectorFull TimeRemoteLeadTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

Kentucky

Posted

18 days ago

Salary

$168K - $231K / year

Seniority

Lead

Bachelor Degree8 yrs expEnglish

Job Description

• Provide HEDIS technical specification expertise and consultation – ensuring operations are appropriately governed by specifications and strategic levers are in-play to optimize measure performance • Lead HEDIS clinical and data integrity audit readiness strategies and continuous monitoring programs to mitigate compliance and regulatory risk • Lead HEDIS clinical curriculum development and delivery to support medical record review and data file integrity activities • Own HEDIS standards for measure interpretation, documentation requirements, and compliance guidance • Own risk management planning related to regulatory submissions, including identification of vulnerabilities and development of mitigation strategies • Provide senior-level communication and recommendations on compliance risks, quality performance, and improvement opportunities • Serve as enablement liaison and collaborator across cross-functional teams and operational swim lanes to ensure alignment of quality initiatives and performance goals • Lead clinical process strategic framework development to support consistent and high-quality HEDIS data collection and submission • Advise and influence team strategy, supporting initiatives, and long-term roadmap; including supporting strategic exploration efforts by shaping pilots, defining success criteria, and guiding execution paths • Lead large-scale, high-impact strategic initiatives to optimize operational efficiencies and performance outcomes • Accelerate shared accountability for continuous improvement by ensuring partner transparency, creating alignment, inspiring action, and delivering tangible results • Foster a culture of quality, accountability, and continuous improvement across quality functions

Job Requirements

  • Bachelor's Degree
  • 8 years of experience in healthcare, clinical operations, portfolio coordination and/or consulting
  • HEDIS experience and expertise
  • Expertise in program administration, planning frameworks and performance tracking
  • Experience leading teams, growing talent and leading cross-functionally
  • Demonstrated success executing strategic initiatives from planning through delivery, ensuring measurable outcomes
  • Experience leading complex cross-functional execution in matrixed environments
  • High organizational agility and innovative thinking
  • Experience and comfort operating at both strategic and tactical levels
  • Strong decision-making skills, particularly with high impact on efficiency, effectiveness, completeness, and accuracy
  • Confidence and comfort in conversing with senior management, business leaders and external parties.

Benefits

  • medical, dental and vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance and many other opportunities

Related Categories

Related Job Pages

More Director Jobs

Clario logo

R&D Director

Clario

Transforming Lives by Unlocking Better Evidence | Decentralized clinical trials | Broadest endpoint technology

Director18 days ago
Full TimeRemoteTeam 5,001-10,000Since 1973H1B Sponsor

R&D Director driving AI integration in software development at Clario

United States

Senior Director, Clinical Pharmacology

Crinetics Pharmaceuticals

Crinetics Pharmaceuticals is dedicated to advancing treatments for rare endocrine diseases, aiming to enhance patients' lives by developing innovative therapies

Director18 days ago
Full TimeRemote

Senior Director of Clinical Pharmacology developing strategies for small molecule therapeutics

California
$238K - $297K / year

Associate Director, Clinical Pharmacology

Crinetics Pharmaceuticals

Crinetics Pharmaceuticals is dedicated to advancing treatments for rare endocrine diseases, aiming to enhance patients' lives by developing innovative therapies

Director18 days ago
Full TimeRemote

Associate Director leading clinical pharmacology strategy in a pharmaceutical company

California
$166K - $208K / year
Full TimeRemoteTeam 1,001-5,000Since 1891H1B No Sponsor

Associate Director driving Execution Excellence in pharmaceutical company's transformation.

New Jersey
$152.6K - $283.4K / year