We’re searching for a Senior Quality Programs Manager, someone who works well in a fast-paced setting. In this position, you’ll be responsible for providing strategic and operational leadership for the organization’s HEDIS program, overseeing planning, execution, monitoring, and continuous improvement activities. This role is accountable for ensuring full compliance with NCQA HEDIS technical specifications while leading the organization’s transition to digital HEDIS reporting, including Electronic Clinical Data Systems (ECDS) and supplemental data sources.

Think you’ve got what it takes?

Job Duties & Responsibilities
•    Ensures organizational success in HEDIS performance through strategic oversight and expert leadership
•    Serves as the HealthPlan SME on HEDIS and digital measurement (Hybrid/ECDS), safeguarding data integrity and audit readiness
•    Drives cross‑functional alignment to translate quality strategy into measurable outcomes
•    Provides clear, actionable performance insights through executive‑level reporting and dashboards
•    Leads efforts to identify best practices, Identifies potential issues, project change and scope
•    Leads engagement with regulators, oversight bodies, and accreditation partners, representing the organization with credibility and confidence
•    Identifies risks, gaps, and improvement opportunities to continuously strengthen quality outcomes
•    Escalates to leaders when metrics are unmet and outliers are identified. Assists with conducting root cause analysis
•    Creates policies, procedures, job aids, and training materials
•    Collaborates with Education to ensure trainings are deployed to internal and external teams
•    Communicates with co-workers on joint projects and initiatives
•    Incorporates ongoing changes to accreditation and regulatory documents trackers

Skills & Requirements

•    Bachelor’s degree in healthcare, healthcare administration or related business degree required
•    CPHQ - Cert-Cert Prof Healthcare Qual by The Certified Professional in Healthcare Quality preferred
•    5 years of experience in a health plan with quality improvement, health plan accreditation and or regulatory reporting required
3 years of experience as a program manager or related role with oversight of multiple programs required

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

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Senior Quality Programs Manager (HEDIS Mgr)