W

Waymark

Community-based Medicaid care coordination and navigation

HEDIS Quality Programs: Principal

Business OperationsConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • At least 7 years of experience in healthcare quality, quality operations, population health, value-based care, managed care, or a related field.
  • At least 5 years of experience with NCQA HEDIS quality measures and performance programs, including translating requirements into implementable, scalable programs and operational workflows.
  • Experience with business intelligence and reporting tools such as Looker, Tableau, Power BI, or equivalent platforms.
  • Strong program and project management skills, including the ability to lead complex, cross-functional initiatives and manage competing priorities in a fast-paced environment.
  • Comfort and demonstrated success driving program execution independently with a bias for action.
  • A 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 and presentation skills for engaging executive leadership, training frontline staff, and building partnerships with cross-functional teams and external stakeholders.
  • Demonstrated ability to identify and manage quality program risks, develop mitigation strategies, and foster a culture of continuous improvement.
  • 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 a matrix environment.
  • Bachelor’s degree.

Responsibilities

  • Own the portfolio of HEDIS contractual quality measures and roadmap across Waymark’s partnerships.
  • Translate measure specifications and partner requirements into executable programs, including building workflows, scoping and directly managing vendor partners for last-mile gap closure (such as home lab visits and at-home diagnostic kit distribution), and building the operational infrastructure to scale them.
  • Conduct retrospectives, root cause analyses, and structured improvement cycles to identify execution friction points and accelerate gap closure.
  • Collaborate with Care Operations and Learning and Development teams to develop and maintain job aids, standard operating procedures, training, and enablement so care teams can execute campaigns consistently.
  • Coordinate supplemental data submissions and reconciliation across payer partners.
  • Partner with Analytics to define measure logic, dashboards, patient lists, gap reporting, and automated monitoring; independently validate outputs and troubleshoot discrepancies.
  • Serve as a subject matter expert for Clinical Product Development to ensure ideation and requirements for new automation and artificial intelligence innovations reflect best practices, reduce manual work, and make HEDIS programs scalable and efficient.
  • Serve as a subject matter expert for Business Development on HEDIS metrics and targets during contract negotiations.
  • Stay informed about industry trends and best practices in quality and clinical management and integrate them into operations and product design.

Desired Qualifications

  • Experience with Medicaid managed care.
  • Lean Six Sigma or related quality improvement certification.
  • A graduate or advanced degree, such as an MPH, MHA, or MBA.

About the Company

Waymark

Community-based Medicaid care coordination and navigation

Waymark Care connects Medicaid patients with local, on-the-ground care teams that include community health workers, therapists, pharmacists, and care coordinators to provide comprehensive care. Its product works by embedding care teams in the patient’s community, helping patients navigate healthcare, coordinate appointments, manage prescriptions, and access additional needs like food, housing, and transportation. The company earns revenue through partnerships with health plans and primary care providers, allowing services to be offered at no cost to patients. As a public benefit corporation, Waymark Care is legally bound to consider patient, community, and public impact in its decisions. Overall, Waymark Care aims to improve access to quality healthcare for Medicaid patients through community-based, patient-centered care.

Company size
51-200
Company stage
Early VC
Total funding
$87M
Headquarters
San Francisco, CA
Founded
2021

Recently Posted Jobs

Explore more opportunities at Waymark

See more jobs