Consultant - Payer Services - Senior Product Engineer - HEDIS Subject Matter Expert
Huron Consulting Group4 days ago
Remote, WorldwideSenior / Staff+
Responsibilities
- Lead data quality initiatives affecting HEDIS, CMS submissions, and regulatory reporting accuracy.
- Assess and resolve data gaps, inconsistencies, lineage issues, and reconciliation problems across payer systems.
- Define data governance frameworks and translate regulatory requirements into functional and technical specifications.
- Serve as an HEDIS and CMS STARs subject matter expert and advise clients on reporting and submission best practices.
- Design and optimize reporting, analytics, predictive-modeling, and data-flow solutions using payer data.
- Collaborate with engineering, data, IT, compliance, business operations, and executive stakeholders on product roadmaps and solutions.
- Lead or contribute to client-facing workshops, design sessions, and strategic advisory discussions.
Requirements
- 7–12+ years of healthcare payer experience with expertise in HEDIS reporting, CMS STARs methodology, regulatory reporting, and quality programs.
- Demonstrated experience in data quality management, reporting, and analytics within payer environments.
- Strong understanding of claims and encounter data, data lifecycles, validation, and reconciliation processes.
- Ability to engage business stakeholders and translate requirements into technical and product solutions.
- Experience in client-facing consulting or product engineering environments.
- Strong communication skills with the ability to work across technical and non-technical teams.
- Applicants must be U.S. Citizens; H-1B, C2C, and 1099 candidates are not considered.
Benefits
- W2 hourly contract with an $85–$100 per hour rate based on relevant experience.
- Remote work arrangement; project duration is subject to change.
- Huron offers medical, dental, and vision coverage, a 401(k) plan with employer match, employee stock purchase plan, paid time off, paid parental leave, adoption assistance, and wellness programs, subject to eligibility requirements.