Senior Director of Quality Operations and HEDIS Strategy

About the Role

A prominent national healthcare organization within managed care is seeking a Senior Director to lead Quality Operations and HEDIS Strategy. This 100% remote role is geared towards an individual who combines strategic insight with a hands-on approach to managing the full HEDIS audit cycle and quality improvement initiatives. The organization focuses extensively on health equity and serves millions of members across the United States.

Key Responsibilities

• Own and manage the complete HEDIS audit lifecycle including creation and oversight of Roadmaps and Section 5 documentation, and direct collaboration with external auditors.
• Engineer and implement detailed process maps and workflows aimed at optimizing quality assurance and performance enhancement efforts.
• Serve as the lead liaison between executive leadership and audit authorities to maintain clear communication and ensure successful audit completion.
• Develop advanced dashboards and data-tracking systems to monitor the organization’s effectiveness and accuracy of HEDIS measurements.
• Ensure strict adherence to regulatory standards including NCQA, URAC, and the Joint Commission across all departments.
• Lead development of policies, procedures, and training programs to foster a corporate culture centered on quality compliance.

Candidate Requirements

• Bachelor’s degree in Healthcare Administration, Business, Clinical field, or related discipline.
• Minimum of six years in leadership roles focused on Quality Management or Process Improvement.
• Extensive practical knowledge and experience with NCQA HEDIS measures and the annual audit process is strongly preferred.
• Proficient in research methodologies, workflow management tools, and data analytics.
• Familiarity with accreditation standards such as URAC and Joint Commission is highly advantageous.
• Demonstrated ability to promote accountability and manage diverse teams effectively in a fast-paced, fully remote environment.

Benefits and Culture

• Competitive salary ranging between $118,000 and $219,000 annually, including performance bonuses.
• Comprehensive medical, dental, and vision insurance.
• 401(k) plan with employer match plus employee stock purchase opportunities.
• Support for continuing education through tuition reimbursement and professional development programs.
• Generous paid time off and holiday arrangements.
• Strong emphasis on workplace flexibility in a fully remote setting.

Equal Opportunity Employer Statement

The employer welcomes applicants from all backgrounds and is committed to equal opportunity employment.