Senior Product Manager / Engineer - HEDIS SME
Core
Senior Product Engineer/Principal acting as a Subject Matter Expert (SME) for HEDIS and CMS reporting, bridging business engagement, product engineering, and healthcare data strategy to improve data quality and regulatory reporting for healthcare payers.
Role type
Senior IC Product Engineer (Healthcare Data & Regulatory Reporting)
Builds
Scalable data quality, regulatory reporting, and analytics solutions for healthcare payer clients
Domain
Healthcare Payer Services, Regulatory Reporting, Data Quality
Deliverable
production ML models | product features | dashboards & analysis
Required skills
HEDIS reporting expertise, CMS STARs methodology, regulatory reporting, data quality management, claims and encounter data, data lifecycle validation, stakeholder engagement, client-facing consulting, technical roadmap translation
Preferred skills
Cognizant CMS Edge Server, Claimsphere, Facets (TriZetto), predictive analytics, risk adjustment, value-based care, SQL, data modeling
Technologies
Cognizant CMS Edge Server, Claimsphere, Facets (TriZetto)
Responsibilities
Lead data quality initiatives for HEDIS and CMS submissions; Assess and resolve data gaps and lineage issues across payer systems; Drive improvements in data validation and reporting processes; Partner with stakeholders to define data governance frameworks; Translate complex regulatory requirements into functional and technical specifications; Lead design and optimization of reporting solutions; Collaborate with engineering teams to deliver scalable reporting products; Develop predictive models and analytics frameworks to improve quality outcomes; Engage with business and executive stakeholders as a strategic advisor; Lead or contribute to client-facing discussions and design sessions
Seniority
Senior, hands-on IC with strategic advisory component