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Salary: USD 127,000 - 157,000 / annual
Waymark is a mission-driven healthcare technology company transforming care delivery for Medicaid beneficiaries through technology-enabled, human-centered support. The company partners with communities to remove barriers and reimagine what's possible in Medicaid healthcare delivery.
As the HEDIS Quality Programs Principal, you will own Waymark's end-to-end approach to contractual quality performance, including HEDIS and partner-specific quality measures. This is a strategic individual contributor role reporting to the Vice President of Care Operations, with responsibility for building and scaling a critical component of Waymark's care model.
Key responsibilities include:
- Owning the portfolio of HEDIS contractual quality measures and roadmap across partnerships
- Translating measure specifications into executable programs, building workflows, and managing vendor partners for gap closure initiatives (e.g., home lab visits, diagnostic kit distribution)
- Conducting retrospectives, root cause analyses, and structured improvement cycles to identify friction points and accelerate performance
- Collaborating with Care Operations and Learning & Development to develop job aids, SOPs, training, and enablement for care teams
- Coordinating supplemental data submissions and reconciliation across payer partners
- Partnering with Analytics to define measure logic, dashboards, patient lists, gap reporting, and automated monitoring; independently validating outputs
- Serving as Subject Matter Expert for Clinical Product Development to ensure new automation and AI innovations reflect best practices and reduce manual work
- Serving as Subject Matter Expert for Business Development on HEDIS metrics and targets during contract negotiations
- Staying informed about industry trends in quality and clinical management and integrating them into operations and product design
Requirements:
- 7+ years of experience in healthcare quality, quality operations, population health, value-based care, managed care, or related field
- 5+ years of experience with NCQA HEDIS quality measures and performance programs, including translating requirements into implementable, scalable programs and operational workflows
- Experience with BI and reporting tools such as Looker, Tableau, Power BI, or equivalent platforms
- Strong program and project management skills with proven ability to lead complex, cross-functional initiatives and manage competing priorities in fast-paced environment
- Demonstrated success driving program execution independently with bias for action
- Proven track record of managing operational vendors or clinical partners to deliver home-based services, diagnostic programs, or field campaigns
- Excellent written and verbal communication skills, including presentation skills for engaging with executive leadership, training frontline staff, and building partnerships
- Demonstrated ability to identify and manage quality program risks, develop mitigation strategies, and foster continuous improvement culture
- Experience designing member outreach campaigns, care-team workflows, tasking, job aids, or training in support of quality measures
- Ability to manage large volumes of data, analyze data, identify data gaps, and develop reporting for performance management
- Ability to work in matrix environment
- Bachelor's degree
Preferred qualifications:
- Experience with Medicaid managed care
- Lean Six Sigma or related quality improvement certification
- Graduate or Advanced Degree (MPH, MHA, MBA)
