National Quality Performance Manager- HEDIS / SQL

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a National Quality Performance Manager- HEDIS / SQL based in United States.

This role provides subject matter expertise across national healthcare quality performance initiatives, with a strong focus on HEDIS, CAHPS, and SQL.
You will collaborate with health plan leaders and cross-functional teams to turn complex quality data into actionable performance improvements.
The position spans quality analytics, data validation, regulatory readiness, reporting, forecasting, and care-gap identification.
You will help strengthen data completeness and accuracy across EHR, HIE, claims, and supplemental data sources.
The role offers broad visibility across a highly collaborative, matrixed healthcare environment and requires strong stakeholder engagement.
You will monitor strategic quality programs from planning through delivery while identifying risks, opportunities, and areas for improvement.
This is a fully remote opportunity for a data-driven quality professional who can combine analytical expertise with effective program management.

• Collaborate with health plan quality leaders to develop and manage quality data collection strategies, analytics, and reporting covering HEDIS performance, quality-rate trending and forecasting, provider performance, CAHPS and survey analytics, health equity, SDOH, and external vendor activities.

• Monitor quality-related programs and projects from initiation through successful delivery, ensuring milestones, resources, deliverables, and timelines remain aligned with strategic objectives.

• Oversee quality data ingestion and validation activities, identify data issues, document findings, and improve the completeness and accuracy of EHR, HIE, and supplemental data.

• Analyze quality performance data to identify trends, risks, care gaps, and opportunities for measurable improvement.

• Support compliance with quality-related regulatory and audit requirements by managing deliverable roadmaps and timelines and implementing solutions that strengthen HEDIS audit readiness and performance.

• Partner with cross-functional teams to maintain data quality across sequential transformations and identify opportunities to close quality-of-care gaps.

• Create, review, and maintain quality program documentation, including project plans, reports, records, analyses, and supporting materials.

• Provide clear and proactive status reporting to stakeholders, communicating progress, risks, issues, dependencies, and recommended actions.

• Build effective relationships with internal and external stakeholders, establish trust, understand customer expectations, and ensure quality initiatives meet business and operational requirements.

• Support enterprise-wide quality performance improvement initiatives through data-driven insights and coordinated execution.

Requirements

• At least 3 years of program or project management experience within healthcare quality, or an equivalent combination of relevant education and professional experience.

• Healthcare industry experience or demonstrated functional knowledge of healthcare quality programs.

• Strong knowledge or practical experience related to HEDIS, NCQA, CAHPS, CMS, and state-specific quality or regulatory submission requirements is preferred.

• Experience with SQL or the ability to run queries using Microsoft Azure or SQL Server is preferred.

• Strong proficiency in data analysis, manipulation, interpretation, reporting, and quantitative problem-solving.

• Ability to translate complex technical or quality concepts into clear, actionable information for diverse stakeholders.

• Strong critical-thinking, analytical, problem-solving, organizational, and attention-to-detail skills.

• Knowledge of healthcare data and coding elements such as CPT, CPT II, LOINC, SNOMED, HCPCS, NDC, CVX, NPI, and TIN is preferred.

• Experience working in a highly matrixed organization, preferably within managed care environments supporting Medicaid, Medicare, and/or Marketplace programs.

• Strong verbal, written, presentation, and stakeholder-management skills.

• Proficiency with Microsoft Office, including Excel, and the ability to quickly learn and navigate new technology and software platforms.

• Ability to collaborate effectively across departments, manage multiple priorities, and maintain progress across complex initiatives.

• PMP certification is preferred.

• Six Sigma Green Belt, Black Belt, or comparable coursework is preferred.

Benefits

• Annual salary range of $59,810.60–$129,589.63, with actual compensation varying based on geographic location, professional experience, education, and skill level.

• Full-time, fully remote position within the United States.

• Opportunity to work on national healthcare quality performance initiatives involving HEDIS, CAHPS, SQL, analytics, and regulatory quality programs.

• Cross-functional exposure to health plan quality, data, analytics, regulatory, and operational teams.

• Opportunity to contribute directly to quality improvement, care-gap closure, data accuracy, and healthcare outcomes.

• Competitive compensation and benefits package.

• Equal employment opportunity workplace.