ECDS & Digital Transformation Program Mgr

About the role

Blue Cross and Blue Shield of Minnesota is seeking a dedicated and motivated individual to join its team. As an ECDS & Digital Transformation Program Manager, you will play a key role in advancing the organization's digital quality transformation.

Responsibilities

• Leads the operational execution of the HEDIS® ECDS strategy aligned to regulatory requirements and enterprise priorities
• Designs and manages the ingestion of clinical data sources to support HEDIS® digital measure reporting
• PARTNERS WITH IT AND DATA ENGINEERING TO DEVELOP AND MAINTAIN DATA PIPELINES SUPPORTING DIGITAL QUALITY REPORTING
• CORPORATES WITH PROVIDER PARTNERS AND CLINICAL TEAMS TO ALIGN DOCUMENTATION AND WORKFLOW PRACTICES WITH ECDS MEASURE REQUIREMENTS
• COORDINATES WITH QUALITY ANALYTICS AND IT TO OPERATIONALIZE DIGITAL QUALITY MEASURES
• MONITORS NCQA AND CMS DIGITAL QUALITY REQUIREMENTS AND DRIVES OPERATIONAL READINESS
• COLLABORATES WITH INTERNAL STAKEHOLDERS TO INTEGRATE DIGITAL QUALITY INSIGHTS INTO BROADER ENTERPRISE QUALITY STRATEGIES
• SUPPORTS OVERSIGHT OF VENDORS DELIVERING DIGITAL QUALITY TECHNOLOGIES, INTEROPERABILITY TOOLS, AND DATA EXCHANGE CAPABILITIES
• DEVELOPS DOCUMENTATION, WORKFLOWS, AND GOVERNANCE PROCESSES TO ENSURE ECDS REPORTING PROCESSES ARE REPEATABLE, AUDITABLE, AND SCALEABLE
• TRACKS RISKS, DEPENDENCIES, AND IMPLEMENTATION MILESTONES ACROSS ECDS INITIATIVES AND ESCALATES ISSUES TO THE HEDIS® MANAGER AND LEADERSHIP AS APPROPRIATE

Requirements

• 5+ years of experience in healthcare quality measurement, healthcare data integration, clinical analytics, or healthcare technology implementation
• Strong understanding of healthcare interoperability frameworks, including EHR data structures, HL7 messaging, and FHIR-based data exchange
• Demonstrated ability to manage complex cross-functional projects involving clinical teams, data teams, IT, and external partners
• Strong analytical and problem-solving skills with the ability to translate regulatory and technical requirements into operational workflows
• Excellent communication skills with the ability to work effectively with technical and non-technical stakeholders

Qualifications

• All relevant experience including work, education, transferable skills, and military experience will be considered
• Experience working with HEDIS® measurement programs, including measures that require clinical data or supplemental data sources
• Experience implementing digital quality measurement initiatives, including HEDIS® ECDS measures or other electronic clinical quality measures
• Familiarity with NCQA digital quality roadmap and emerging digital quality initiatives
• Experience working with healthcare interoperability platforms, data exchange vendors, or health information exchanges
• Understanding how digital clinical data can support broader enterprise initiatives such as Stars, provider performance management, value-based care, and population health analytics
• Strong project management capabilities with experience leading multi-year transformation initiatives

Skills

• Bachelor’s or master’s degree in healthcare administration, public health, informatics, data science, business, or a related field
• Experience with digital quality measurement initiatives, including HEDIS® ECDS measures or other electronic clinical quality measures
• Familiarity with NCQA digital quality roadmap and emerging digital quality initiatives
• Experience working with healthcare interoperability platforms, data exchange vendors, or health information exchanges
• Understanding how digital clinical data can support broader enterprise initiatives such as Stars, provider performance management, value-based care, and population health analytics
• Strong project management capabilities with experience leading multi-year transformation initiatives

Benefits

Compensation Range: $90,800.00 - $120,300.00 - $149,800.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We Offer a Comprehensive Benefits Package Which May Include Medical, Dental, and Vision Insurance, Life Insurance, 401(k), Paid Time Off (PTO), Volunteer Paid Time Off (VPTO), and more. To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com. Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.