Senior Product Manager – HEDIS SME

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Lead initiatives focused on data quality that influence HEDIS, CMS submissions, and the accuracy of regulatory reporting.

• Evaluate, identify, and address data gaps, inconsistencies, and lineage challenges across payer systems.

• Propel enhancements in data validation, reconciliation, and reporting processes to guarantee compliance and performance accuracy.

• Collaborate with stakeholders to establish and implement data governance frameworks and standards.

• Act as a Subject Matter Expert (SME) for HEDIS measures and CMS STARs rating methodologies, ensuring that reporting and performance strategies are aligned.

• Convert intricate regulatory requirements into functional and technical specifications.

• Aid in measurement strategy, performance monitoring, and reporting optimization to enhance STARs outcomes.

• Provide advisory assistance to payer clients regarding best practices for CMS data submission and reporting.

• Lead the design and optimization of solutions utilizing Cognizant CMS Edge Server, Claimsphere, and core payer platforms (e.g., Facets).

• Facilitate integration and data flow across claims, encounter, and reporting systems.

• Work with engineering teams to deliver scalable reporting and analytics products.

• Develop and implement predictive models and analytics frameworks to enhance quality outcomes and STARs performance.

• Enable advanced analytics capabilities by leveraging payer data to uncover trends, risks, and opportunities.

• Transform reporting solutions into forward-looking, insights-driven platforms.

• Engage directly with business and executive stakeholders, serving as a strategic advisor.

• Convert business needs into technical roadmaps and product solutions.

• Lead or participate in client-facing discussions, workshops, and design sessions.

• Collaborate across multidisciplinary teams (data, IT, compliance, business operations).

⛳️ Requirements

• 7–12+ years of experience in the healthcare payer sector.

• Strong domain knowledge in HEDIS reporting.

• Familiarity with CMS STARs methodology.

• Experience in regulatory reporting and quality programs.

• Proven track record in data quality management, reporting, and analytics within payer environments.

• Solid understanding of Claims and encounter data.

• Knowledge of data lifecycle, validation, and reconciliation processes.

• Demonstrated ability to engage business stakeholders and translate their requirements into effective solutions.

• Experience in client-facing consulting or product engineering roles.

• Exceptional communication skills with the ability to interface effectively across both technical and non-technical teams.

🏝️ Benefits

• Comprehensive medical, dental, and vision coverage for employees and their dependents.

• 401(k) plan with a generous employer matching contribution.

• Employee stock purchase plan.

• Generous Paid Time Off policy.

• Paid parental leave and adoption assistance.

• Wellness Program that fosters employee well-being through free annual health screenings, coaching, banking at work, and on-site workshops.