Director, HEDIS and Quality Performance (Fully Remote)

Develop and lead the multi-year enterprise HEDIS strategy, including Medicare Advantage Star Ratings measures, with clear targets and performance routines. Oversee the full HEDIS lifecycle, including data acquisition, chart retrieval, validation, audit readiness, and digital quality measurement. Monitor performance across measures, providers, and products; identify gaps and drive corrective action. Qualifications: Minimum 7 years leading HEDIS strategy and improvement in a health plan, with measurable results on Star Ratings. Demonstrated expertise in ECDS reporting, clinical data interoperability (FHIR), and CMS/NCQA requirements. Proven ability to lead complex cross-functional initiatives in a matrixed organization with strong analytical and communication skills. About Us: Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association, committed to improving member and community health. We foster a flexible environment where wellbeing is prioritized and offer generous benefits and professional growth opportunities. Capital Blue Cross Capital Blue Cross is a health insurance company and independent licensee of the Blue Cross Blue Shield Association, focused on improving the health and well-being of its members and communities. The company fosters a flexible, caring culture and is consistently voted one of the "Best Places to Work in PA." #J-18808-Ljbffr