Sr. Program Manager, HEDIS

Blue Cross and Blue Shield Association
Washington, DC
Apr 20, 2017
Apr 21, 2017
Full Time
**Overview:** Responsible for leading multiple quality initiatives, projects, services and associated deliverables related to the Federal Employee Program (FEP). Functions as the subject matter expert for HEDIS performance measurement. Provides management and direction to Plans and makes strategic recommendations to proactively address Plan quality initiatives and needs. Provides support to the FEP Accreditation Program as it relates to quality standards. Leads cross-functional projects and teams developing project scope and requirements to meet Plan needs. Increases the value of the services for Plan, FEP and other key customers. **Responsibilities:** Responsibilities include but are not limited to: + Provides management and training of HEDIS performance measurements and mandated reporting. Provides recommendations to local Plans and oversight of key quality initiatives. + Resolves complex issues and develop Plan communication strategies to assure HEDIS quality interventions are consistent with FEP strategy. + Support and assist Plans in the use of methodologies, benefit cost initiatives and vehicles to achieve high levels of FEP quality improvement performance. + Represents department at key meetings and serves on committees convened by HEDIS User Groups, Quality Oversight Group and other national organizations. Provides updates and status reports on key quality issues to Senior management. **Qualifications:** **Required Basic Qualifications:** + Minimum five years related business experience which demonstrates knowledge of PPO line of business and care management + Expert in quality with demonstrated knowledge of performance measurements (HEDIS and NQF) + Knowledge of accreditation standards (NCQA, URAC, JCAHO) + Healthcare industry knowledge, including managed care, healthcare reform, contracting and quality + Ability to interact effectively with senior management, both internal to BCBSA and externally + Excellent interpersonal and communication skills + Advanced conflict management skills + Ability to handle multiple projects and meeting deadlines + Advanced presentation skills with the ability to plan, facilitate and present at meetings + Advanced analytical skills with the ability to analyze, interpret data and conduct advanced analysis **Preferred Basic Qualifications:** + Active Nursing License + Master's Degree + Licensed Health Care Professional + CPHQ + AHRQ EEO Minorities/Gender/Disability/Veterans **Job ID** _2017-2387_ **\# of Openings** _1_ **Job Locations** _US_ _-_ _DC_ _-_ _Washington_ **Category** _Quality Improvement_

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