HEDIS Technical Manager

About the Role: BlueCross BlueShield of Tennessee is hiring a HEDIS Technical Manager. In this critical leadership role, you'll own the technical execution of our HEDIS program, with primary responsibility for HEDIS reporting systems, audits, and vendor delivery that support NCQA accreditation and Medicare Advantage Star Ratings. You'll serve as the technical authority for HEDIS specifications, digital measures, and audit responses.

What You'll Do

• Work with internal and external stakeholders to deliver effective analytic solutions that meet business needs.
• Assess the scope and resources required for a wide variety of analytic requests, data modifications, and enhancements.
• Manage the Cotiviti vendor relationship and a team of internal specialists.
• Own and lead HEDIS audits, responding to NCQA audit inquiries.
• Monitor and communicate key performance metrics, escalate issues appropriately, and work with senior management for resolution.

What You Bring

• Bachelor's Degree in Business, Computer Sciences, or related fields.
• 8+ years of extensive systems analysis, design, and project management experience.
• 5+ years in a leadership/management role.
• Deep payer-side HEDIS experience, including strong clinical and technical understanding of HEDIS specifications and codes.
• Technical fluency with healthcare data and analytics (SQL, Google BigQuery, GCP experience).
• Familiarity with digital HEDIS measures and interoperability standards (FHIR).

Benefits

• Directly influence enterprise quality outcomes and support a mission of "peace of mind through better health."
• Opportunity to lead and grow a technical team within a major healthcare organization.
• Fully remote work flexibility within the USA.