[Remote] Senior Product Manager / Engineer - HEDIS SME

Note: The job is a remote job and is open to candidates in USA. Huron helps its clients drive growth and enhance performance in the healthcare sector. They are seeking a Senior Product Manager / Engineer to support healthcare payer clients in advancing data quality, regulatory reporting, and analytics capabilities, focusing initially on HEDIS reporting and evolving into predictive analytics.ResponsibilitiesLead data quality initiatives impacting HEDIS, CMS submissions, and regulatory reporting accuracyAssess, identify, and resolve data gaps, inconsistencies, and lineage issues across payer systemsDrive improvements in data validation, reconciliation, and reporting processes to ensure compliance and performance accuracyPartner with stakeholders to define and implement data governance frameworks and standardsServe as SME for HEDIS measures and CMS STARs rating methodologies, ensuring alignment of reporting and performance strategiesTranslate complex regulatory requirements into functional and technical specificationsSupport measurement strategy, performance monitoring, and reporting optimization to improve STARs outcomesProvide advisory support to payer clients on CMS data submission and reporting best practicesLead design and optimization of solutions leveraging: Cognizant CMS Edge Server, Claimsphere, Core payer platforms (e.g., Facets)Drive integration and data flow across claims, encounter, and reporting systemsCollaborate with engineering teams to deliver scalable reporting and analytics productsDevelop and implement predictive models and analytics frameworks to improve quality outcomes and STARs performanceEnable advanced analytics capabilities using payer data to identify trends, risks, and opportunitiesEvolve reporting solutions into forward-looking, insights-driven platformsEngage directly with business and executive stakeholders, acting as a strategic advisorTranslate business needs into technical roadmaps and product solutionsLead or contribute to client-facing discussions, workshops, and design sessionsCollaborate across multi-disciplinary teams (data, IT, compliance, business operations)Skills7–12+ years of healthcare payer experience, with strong domain expertise in: HEDIS reporting, CMS STARs methodology, Regulatory reporting and quality programsDemonstrated experience in data quality management, reporting, and analytics within payer environmentsStrong understanding of: Claims and encounter data, Data lifecycle, validation, and reconciliation processesProven ability to engage business stakeholders and translate requirements into solutionsExperience working in client-facing consulting or product engineering environmentsStrong communication skills with ability to interface across technical and non-technical teamsHands-on experience with: Hedis Reporting SME, Cognizant CMS Edge Server, Claimsphere, Facets (TriZetto) or similar payer platformsExperience with predictive analytics / data science applications in healthcareBackground in risk adjustment, quality improvement, or value-based care programsSQL, data modeling, or advanced analytics tool experienceCompany OverviewHuron is a global professional services firm that collaborates with organizations to solve complex challenges and achieve ambitious goals. It was founded in 2002, and is headquartered in Chicago, Illinois, USA, with a workforce of 5001-10000 employees. Its website is http://www.huronconsultinggroup.com.