BlueCross BlueShield of Tennessee is seeking a HEDIS Technical Manager to lead the technical execution of their HEDIS program, focusing on reporting systems, audits, and vendor management. Ideal candidates should possess extensive payer-side HEDIS experience, strong technical skills in healthcare analytics, and leadership capabilities
Job Summary
This critical leadership role owns the technical execution of the HEDIS program to support NCQA accreditation and Medicare Advantage Star Ratings.
The ideal candidate will bring deep payer-side HEDIS experience including strong clinical and technical understanding of specifications and audit requirements.
Candidates must possess technical fluency with healthcare data analytics using SQL, Google BigQuery, and GCP experience.
Matching Summary
Match Score: 85
BlueCross BlueShield of Tennessee is seeking a HEDIS Technical Manager to lead the technical execution of their HEDIS program, focusing on reporting systems, audits, and vendor management. Ideal candidates should possess extensive payer-side HEDIS experience, strong technical skills in healthcare analytics, and leadership capabilities.
Skills & Requirements
Must-have
Deep payer-side HEDIS experience
Hands-on HEDIS audit leadership
Cotiviti Platform vendor management
SQL and Google BigQuery fluency
FHIR interoperability standards knowledge
Nice-to-have
Digital HEDIS measures familiarity
Evolving NCQA quality reporting models
Strong clinical understanding of codes
Mission-driven peace of mind focus
Key Requirements
Bachelor's Degree in Business or Computer Sciences
8 years systems analysis and project management experience