Program Manager II, Quality Reporting – Data Governance

Community Health Plan of Washington

. Serve as subject matter expert and strategic partner for quality reporting, data governance, quality assurance, quality control, and regulatory reporting .

Posted 10/23/2026full-timeRemote • Washington • United StatesMid-LevelSenior💰 $80,940 - $125,460 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in quality assurance, regulatory reporting, and data governance within healthcare settings, with a strong focus on HEDIS and compliance frameworks. Proficient in project management methodologies and tools, ensuring operational consistency and effective stakeholder communication.

Highest-signal resume keywords

Quality AssuranceRegulatory ReportingProject ManagementData GovernanceHEDIS

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

SQLData ValidationProcess ImprovementQuality ControlRoot-Cause AnalysisAudit ReadinessData Accuracy MonitoringPerformance ImprovementChange ManagementAdvanced Excel Functionality

Soft Skills

Analytical SkillsOrganizational SkillsPresentation SkillsStakeholder CommunicationCollaboration

Tools & Technologies

Microsoft Office SuiteSharePointConfluenceJIRASmartsheet

Certifications & Qualifications

PMPAgile Professional

Industry Keywords

HEDISCMSMedicaidMedicareQuality ImprovementCommunity Health CentersFederally Qualified Health CentersValue Based Payment ProgramsRisk AdjustmentNCQA

Tech Stack

Tools & technologies

PMPSQL

About the role

Key responsibilities & impact

Serve as subject matter expert and strategic partner for quality reporting, data governance, quality assurance, quality control, and regulatory reporting
Lead quality assurance and quality control processes for HEDIS, PMRR, CAHPS, QHP, HOS, and related quality measurement programs
Develop, implement, and monitor quality controls for data accuracy, regulatory compliance, audit readiness, and operational consistency
Partner with internal teams, third-party auditors, and vendors on compliance, audit readiness, and program execution
Oversee resolution of audit findings, quality concerns, and compliance risks
Improve quality assurance and quality control frameworks, including validation methodologies, quality reviews, audit protocols, issue tracking, and corrective action plans
Monitor control effectiveness and recommend risk-reduction and performance improvements
Lead validation activities assessing accuracy, completeness, consistency, and reliability of regulatory reporting and performance data
Conduct root-cause analysis of quality defects, reporting discrepancies, and audit findings
Recommend corrective and preventive actions and strengthen data governance processes
Coordinate mock audits, control testing, documentation reviews, quality monitoring, and remediation planning
Ensure readiness for NCQA, CMS, state, and external audit requirements
Monitor vendor performance, contractual compliance, and quality initiative metrics
Facilitate quality governance documentation, reporting controls, policy adherence, and communication of risks and recommendations to leadership
Develop and maintain project plans, milestones, tasks, and completion dates
Set SMART goals, allocate resources, track timelines, remove barriers, escalate risks, and propose mitigation strategies
Monitor industry trends, regulatory changes, and best practices to identify strategic opportunities
Maintain stakeholder communication and provide project status, issue, and recovery-plan updates
Establish professional relationships with key partners and keep stakeholders engaged throughout the project lifecycle

Requirements

What you’ll need

Bachelor’s degree in Business Administration, Health Information Management, Healthcare Administration, Analytics, or another relevant academic field, or an equivalent combination of education and/or highly relevant experience
3+ years’ experience in program management, preferably related to HEDIS, CMS Star, Value Based Payment Programs, Risk Adjustment, or general healthcare
PMP, Agile Professional, or other formal project management certification preferred
Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint), including advanced Excel functionality
Experience utilizing SharePoint, Confluence, JIRA, or Smartsheet for project management, workflow tracking, documentation, issue management, operational planning, and cross-functional collaboration
Experience in program development, product development, process improvement, and evaluation strongly preferred
Working knowledge of SQL and/or Snowflake data environments, including querying and validating data, supporting reporting activities, investigating data quality issues, and partnering with analytics, engineering, and technical teams preferred
Experience with Community Health Centers, Federally Qualified Health Centers, or other healthcare systems focused on people with low income and/or barriers to equitable healthcare preferred
Knowledge of Medicaid, Medicare, and/or Exchange principles and practices, including CMS, NCQA, PQA, Milliman, and/or Acumen, with emphasis on quality improvement
Strong analytical skills and ability to interpret data, identify trends, summarize information, and communicate it concisely
Strong vendor management, objective targeting, and service level agreement monitoring skills
Knowledge and experience leveraging change management principles, practices, and methodologies
Ability to adapt to dynamic environments and manage multiple tasks and projects
Ability to work independently and collaboratively
Ability to work accurately and meet established deadlines
Strong organizational skills
Strong presentation skills for complex data, reports, and training
Successfully pass a criminal background check
Must not be sanctioned or excluded from federal or state healthcare programs

Benefits

Comp & perks

10% annual incentive target based on company, department, and individual performance goals
Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts
Health Savings Accounts
Basic Life AD&D
Short- and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching
Identity Theft Protection
PTO accrual starting at 17 days per year
40 hours Community Service volunteer time
10 standard holidays
2 floating holidays
Compassion time off
Jury duty leave
Reasonable accommodation for disabilities