HEDIS Quality Programs, Principal

Waymark is a mission-driven team of healthcare providers, technologists, and builders working to transform care for people with Medicaid benefits. We partner with communities to deliver technology-enabled, human-centered support that helps patients stay healthy and thrive. We’re designing tools and systems that bring care directly to those who need it most—removing barriers and reimagining what’s possible in Medicaid healthcare delivery.

Our Values

At Waymark, our values are the foundation of how we work, grow, and support one another:

• Bold Builders: We tackle the toughest challenges in care delivery by harnessing the power of community and technology.
• Humble Learners: We seek feedback, embrace diverse perspectives, and welcome challenges to our assumptions.
• Experiment to Improve: We use data to inform decisions and continuously assess our performance.
• Focused Urgency: Our mission drives us to act swiftly and relentlessly in pursuit of meaningful results.

If this resonates with you, we invite you to bring your creativity, energy, and curiosity to Waymark.

As the HEDIS Quality Program Principal at Waymark, you will own Waymark’s approach to contractual quality performance, including HEDIS and partner-specific quality measures. You will own the end-to-end operationalization of quality measures and campaigns—from understanding the measure and identifying the opportunity, to designing and deploying high-impact programs, developing workflows, job aids and enablement, coordinating implementation, monitoring execution, and evaluating performance. Reporting to the Vice President of Care Ops, this is an opportunity to build and scale a critical component of Waymark’s care model, improve patient outcomes, and improve contractual performance. 

• →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 and scoping and directly managing vendor partners, including for “last-mile” gap closure (eg, home lab visits, 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 the job aids, SOPs, training, and enablement needed for care teams to execute campaigns consistently.
• →Coordinate supplemental data submissions and reconciliation across payer partners.
• →Partner with the Analytics team 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 the Clinical Product Development team to ensure the ideation and requirements for new automation and AI innovations reflect best practices, reduce manual work, and make HEDIS programs scalable and efficient. 
• →Serve as a Subject Matter Expert for the Business Development team on HEDIS metrics and targets during contract negotiations. 
• →Stay informed about industry trends and best practices in quality and clinical management and integrate into our operations and product design. 

• 7+ years of experience in healthcare quality, quality operations, population health, value-based care, managed care, or a related field.
• 5+ years experience with NCQA HEDIS quality measures and performance programs, including translating requirements into implementable, scalable programs and operational workflows.
• Experience with BI and reporting tools such as Looker, Tableau, Power BI, or equivalent platforms.
• Strong program and project management skills with a proven 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.
• 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 skills, including presentation skills, for engaging with executive leadership, training frontline staff, and building strong 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
• Must be able to work in a matrix environment
• Bachelor’s degree 

• Experience with Medicaid managed care
• Lean Six Sigma or related quality improvement certification
• Graduate or Advanced Degree (MPH, MHA, MBA)

The expected hiring range for this role is $127,000 – $157,000, depending on relevant experience, skills, and qualifications.
This is a remote role, however, candidates living in certain high-cost of living cities such as San Francisco, New York City, and Seattle, may be eligible for an additional market premium.