Manager, HEDIS Operations

Blue Cross Blue Shield of Wyoming

$75K — $95K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Health Care Administration, Business, or related field required; Master's preferred.
  • Five years of progressive experience in relevant roles with technical knowledge required.
  • Two years of supervisory or leadership experience in a related field preferred.
  • Strong analytical skills necessary for evaluating complex data trends.
  • Proficiency in Microsoft Office Suite, particularly PowerPoint, Word, and Excel essential.

Responsibilities

  • Drive strategic direction and execution of HEDIS improvement projects.
  • Collaborate with internal teams and external vendors to enhance quality programs.
  • Research and propose innovative solutions to improve care delivery.
  • Lead data analysis to identify trends and develop initiatives to address care gaps.
  • Oversee the implementation of new strategies for HEDIS projects.

Benefits

  • Best-in-class health insurance at minimal to no cost for employees.
  • Annual review of compensation for market match and eligibility for merit increases.
  • Monthly performance-based incentives and potential commissions for sales roles.
  • Comprehensive benefits supporting physical, financial, and emotional wellness.
  • Generous paid time off policy along with 10 paid holidays and 8 paid volunteer hours.
  • Flexible work-from-home options for eligible positions and a casual dress code.
Full Job Description
Manager, HEDIS Operations
As the manager of HEDIS Operations at BCBSWY, you will be driving strategic direction and execution of HEDIS improvement projects.

You will work with intra-agency teams, vendors, executive leadership and others to build and administer a comprehensive quality program providing the best possible care for our members. Accountabilities include researching and proposing new solutions and assisting in the implementation of those new strategies. You will lead research, analysis, identification and evaluation of data to evaluate existing and potential trends and develop programs to address care gaps.

To be successful in this role, you will need excellent analytical, organizational, planning, verbal and written communications skills. You must possess the ability to manage multiple projects in a fast paced environment and meet necessary deadlines. Strong experience with Microsoft packages, including PowerPoint, Word and Excel is essential.

Minimum qualifications include a bachelor's degree in Health Care Administration, Business, or a related field. A master's degree is preferred. Five (5) years of experience in progressive responsibility with demonstrated technical knowledge is required. Two (2) years supervisor or lead experience in related field preferred.

BCBSWY Employees Enjoy:

Best-In-Class Health Insuranceat minimal to no-cost for BCBSWY employees! PLUS many other benefits along with highly competitive compensation!

Our compensation program is reviewed for competitive market match on an annual basis and employees are eligible for annual merit increases. Monthly incentives that are based on individual and company performance are also available to eligible employees and members of our Sales Team can realize generous performance-based commissions.

At BCBSWY our employees are provided best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include medical, dental, vision, 401(k), life insurance, paid time off (PTO), 10 paid holidays in addition to PTO annually, plus 8 paid volunteer hours, various wellness programs, and a dress code of "Dress for Your Day!" which can mean jeans every day (depending on your role).

Serving Those Who Call Wyoming Home.

Our positions are all based in Wyoming. Depending on the department and the position, eligible employees may be offered limited In-Office/WFH flexibility (for those positions that are offered limited WFH, there will be a required number of In-Office days per week/month depending on department). Executive level employees are required to reside full-time in Wyoming.

Our Selection Process:

Typically includes the following (NOTE: process steps may differ depending on role applied for)

  • Review of your completed application and any additional submitted materials (e.g., cover letter, certifications, etc.) for minimum qualifications and skills alignment.
  • Confirmation of Wyoming residency, intent to become a Wyoming resident, or reasonable commuter distance if Colorado resident.
  • Recruiter Phone Screen.
  • Possible Self-Assessment and/or Questionnaire.
  • Initial interview with Hiring Manager.
  • Possible 2nd Interview with Hiring Manager and/or additional Team members.
  • Comprehensive Background Check.

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