Principal, HEDIS Quality Programs
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Posted: 10/16/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing HEDIS quality measures and operational workflows, with a strong focus on program execution and cross-functional collaboration. Proficient in data analysis and reporting, with a commitment to continuous improvement in healthcare quality and population health.
Highest-signal resume keywords
HEDIS Quality MeasuresProgram ManagementData AnalysisVendor ManagementLean Six Sigma Certification
Tech Stack
Tools & technologiesAbout the role
Key responsibilities & impact- Own Waymark’s portfolio of HEDIS contractual quality measures and roadmap across partnerships.
- Translate measure specifications and partner requirements into executable programs, workflows, and scalable operational infrastructure.
- Scope and directly manage vendor partners for last-mile gap closure, including home lab visits and at-home diagnostic kit distribution.
- Conduct retrospectives, root cause analyses, and structured improvement cycles to accelerate gap closure.
- Collaborate with Care Operations and Learning and Development teams on job aids, SOPs, training, and enablement.
- Coordinate supplemental data submissions and reconciliation across payer partners.
- Partner with Analytics to define measure logic, dashboards, patient lists, gap reporting, and automated monitoring; validate outputs and troubleshoot discrepancies.
- Advise Clinical Product Development as a subject matter expert on HEDIS best practices, automation, and AI innovations.
- Advise Business Development on HEDIS metrics and targets during contract negotiations.
- Monitor industry trends and best practices in quality and clinical management and integrate them into operations and product design.
- Report to the Vice President of Care Operations.
Requirements
What you’ll need- 7+ years of experience in healthcare quality, quality operations, population health, value-based care, managed care, or a related field.
- 5+ years experience with NCQA HEDIS quality measures and performance programs, including translating requirements into implementable, scalable programs and operational workflows.
- Experience with BI and reporting tools such as Looker, Tableau, Power BI, or equivalent platforms.
- Strong program and project management skills with a proven ability to lead complex, cross-functional initiatives and manage competing priorities in a fast-paced environment.
- Comfort and demonstrated success driving program execution independently with a bias for action.
- Proven track record of managing operational vendors or clinical partners to deliver home-based services, diagnostic programs, or field campaigns.
- Excellent written and verbal communication skills, including presentation skills, for engaging with executive leadership, training frontline staff, and building strong partnerships with cross-functional teams and external stakeholders.
- Demonstrated ability to identify and manage quality program risks, develop mitigation strategies, and foster a culture of continuous improvement.
- Experience designing member outreach campaigns, care-team workflows, tasking, job aids, or training in support of quality measures.
- Ability to manage large volumes of data, analyze data, identify data gaps and develop reporting for performance management.
- Must be able to work in a matrix environment.
- Bachelor’s degree.
- Employment is contingent upon successful completion of a background check.
- Medicaid managed care experience preferred.
- Lean Six Sigma or related quality improvement certification preferred.
- Graduate or Advanced Degree (MPH, MHA, MBA) preferred.
Benefits
Comp & perks- Stock Options: Opportunity to invest in the company’s growth.
- Work-from-Home Stipend: A dedicated stipend for your first year to help set up your home office.
- Incentive Program: Receive additional compensation through performance-based incentives that align with organizational goals and enhance patient outcomes.
- Medical, Vision, and Dental Coverage: Comprehensive plans to keep you and your family healthy.
- Life Insurance: Basic life insurance to give you peace of mind.
- Paid Time Off: 20 vacation days, accrued over the year, plus 11 paid holidays.
- Parental Leave: 16 weeks of paid leave for birthing parents after six months of employment, and 8 weeks of bonding leave for non-birthing parents.
- Retirement Savings: Access to a 401(k) plan with a company contribution, subject to a vesting schedule.
- Commuter Benefits: Convenient options to support your commute needs.
- Professional Development Stipend: A dedicated stipend supports professional development and growth.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Healthcare QualityPopulation HealthValue-Based CareOperational WorkflowsQuality ImprovementData ReportingRisk ManagementMember Outreach CampaignsClinical ManagementContract Negotiations
Soft Skills
Excellent CommunicationCross-Functional CollaborationLeadershipProblem SolvingTraining and Development
Tools & Technologies
LookerTableauPower BIBI Reporting Tools
Certifications & Qualifications
Lean Six Sigma CertificationMPHMHAMBA
Industry Keywords
Managed CareNCQAQuality OperationsClinical PartnershipsHome-Based Services