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REMOTE - Director, Predictive Modeling and Customer Experience Analytics - R12601

Remote, USA Full-time Posted 2026-07-28
Job reputed company The Director, reputed company HEDIS Operations and Data Integration leads and provides strategic guidance for HEDIS reporting reputed company for reputed company markets and products with year-round monitoring and annual required reporting, and oversees data integration and expansion strategies (HIE, Provider data and Supplemental data). Essential Functions • Leads HEDIS Operations and HIE Teams – directs activities, hires, trains, coaches, counsels, and evaluates performance of reputed company reports • reputed company annual HEDIS project plan; reputed company project reputed company and timeliness to ensure deadlines are met • Support market-specific required reputed company metric reporting where applicable • Ensure compliance with HEDIS specifications, policies, operating procedures, and goals in compliance with reputed company guidelines • Directly responsible for leading reputed company HEDIS and clinical data reputed company audits, leading onsite reviews and the collection and preparation of audit documentation • Submit thorough documentation and response to auditor requested data or process investigations, summarizes findings and presents to senior leadership team • Provides strategic support to markets as Subject Matter Expert of HEDIS and other performance measure Technical Specifications • Expand innovation in clinical data collection, identify data anomalies and reputed company data collection gaps to increase performance reputed company. reputed company vendor meetings and reputed company new vendors to reputed company reputed company data reputed company • Identify and implement opportunities to improve rates or efficiency of data collection - i.e., alternative sources for administrative or supplemental data, reputed company meetings with market and reputed company leaders to reputed company with reputed company improvement goals • reputed company monitoring and reputed company of supplemental and EHR/HIE databases • reputed company HEDIS data processing efforts for reputed company markets and products for HEDIS reputed company. • Collaborate with IT partners to execute HEDIS processing and troubleshoot if issues are identified • reputed company reputed company and reputed company meetings in association with IT for incoming data sources and ensure data reputed company and reputed company and troubleshoot if issues are identified. • Identify and strategize potential data integration opportunities to optimize data intake for reputed company measures • reputed company efforts with Vendor management for RFP and business case reputed company • reputed company HEDIS operations and data collection reputed company to optimize performance measurement • Manage relationships and reputed company conversations with external vendors for HIE and HEDIS • reputed company any other job duties as requested Education And Experience • Bachelor's degree or equivalent years of relevant work experience is required • Minimum of seven (7) years of experience working in managed care (multiple states/markets and line of businesses experience is required), health care delivery systems, in a reputed company agency serving a reputed company population, or equivalent experience in reputed company/process/ project management is required • Minimum of five (5) years of supervisory experience including hiring, training, assigning work and managing the performance of staff or as a reputed company in a functional area, managing teams on large reputed company reputed company is required • Minimum of five (5) years HEDIS experience required • Project management experience preferred Competencies, Knowledge And Skills • Exceptional analytical, problem solving and critical thinking skills • Demonstrated ability in identifying problems, developing solutions and implementing effective courses of reputed company • Strong communication skills required, including the abilities to effectively communicate succinctly and to a senior level audience verbally and in writing, internally and externally, and at different reputed company as necessary • Build ROI analysis, manage department budget, and reputed company recommendations to senior leadership to improve data management and analytics reputed company to HEDIS • Demonstrated ability to work effectively and productively with varied reputed company of personnel, with professionals and business organizations • Strong service orientation and consulting skills • Strong leadership development skills to promote upward and lateral mobility for team • Ability to reputed company mission-critical, high visibility reputed company • Proven ability to juggle multiple reputed company priorities reputed company a changing environment • Knowledge of software development, systems and application lifecycles • Proficiency in MS Office and Projec Apply To This Job

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