Also referred to as:
HEDIS Quality Director
Requirements and Responsibilities
HEDIS Program Director directs the organization's HEDIS quality reporting and improvement program to ensure accurate measure capture and drive gains in clinical quality performance. Provides knowledge and oversight of HEDIS measures and compliance to drive continuous improvement of quality, effectiveness, and safety of health plans. Being a HEDIS Program Director oversees annual HEDIS data collection and submission to NCQA and applicable regulators. Develops improvement strategies and provider-facing interventions to close care gaps across preventive, chronic, and behavioral health measures. Additionally, HEDIS Program Director ensures compliance with NCQA technical specifications, audit requirements, and reporting deadlines. Manages departmental staff, budgets, and analytics to sustain measurable quality improvement. Requires a bachelor's degree. Typically reports to senior management. The HEDIS Program Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a HEDIS Program Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function.
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