Lead, Data Quality/Integrity – Clinical Abstraction Operations

Vendor Management

• Lead and manage external vendors responsible for clinical abstraction to close HEDIS gaps, ensuring compliance with contractual obligations, quality standards, and regulatory requirements.
• Oversee and participate in medical record review and abstraction processes for both hybrid and supplemental HEDIS seasons, ensuring accuracy, completeness, and timeliness of data collection.

Medical Record Review

• Oversee and participate in medical record review and abstraction processes for both hybrid and supplemental HEDIS seasons, ensuring accuracy, completeness, and timeliness of data collection.
• Provide clinical expertise in medical record review to support enterprise-wide initiatives involving medical record data quality, master data management, and supplemental data integration.

Training & Support

• Deliver training, guidance, and best practices to both internal teams and external partners regarding clinical abstraction, HEDIS documentation, and data management protocols.

Stakeholder Collaboration

• Advise business and technical leaders in developing segment-specific functional strategies for master data management, exercising independent judgment on significant matters.

Required Qualifications

• Bachelor’s degree in Computer Science, Management Information Systems, Engineering, Math, Business, Nursing, Health Information Management, or a related field.
• 5+ years of technical and/or clinical data management experience, with a demonstrated track record in data quality, integrity, or master data management.
• Minimum 2 years of project leadership or supervisory experience.
• Experience in Healthcare Operations.
• Experience with data quality management principles, data architecture, and familiarity with analytics/reporting tools.
• Strong analytical, organizational, and communication skills.
• Demonstrated ability to articulate ideas effectively in both written and oral forms.
• Demonstrated ability to work independently, exercise sound judgment, and make decisions in complex, variable environments.
• Passion for improving consumer and clinical data experiences.