Leads the operational execution of the HEDIS® ECDS strategy aligned to regulatory requirements and enterprise priorities
Designs and manages the ingestion of clinical data sources to support HEDIS® digital measure reporting
Partners with IT and data engineering to develop and maintain data pipelines supporting digital quality reporting
Coordinates with provider partners and clinical teams to align documentation and workflow practices with ECDS measure requirements
Supports the transition from claims/encounter-based and manual abstraction processes to scalable electronic clinical data reporting
Establishes accountability for validation of data completeness, accuracy, and NCQA compliance
Partners with Quality Analytics and IT to operationalize digital quality measures
Monitors NCQA and CMS digital quality requirements and drives operational readiness
Collaborates with internal stakeholders to integrate digital quality insights into broader enterprise quality strategies
Supports oversight of vendors delivering digital quality technologies, interoperability tools, and data exchange capabilities.
Develop documentation, workflows, and governance processes to ensure ECDS reporting processes are repeatable, auditable, and scalable.
Track risks, dependencies, and implementation milestones across ECDS initiatives and escalate issues to the HEDIS® Manager and leadership as appropriate.
Performs additional responsibilities consistent with the scope and level of the role, as assigned
Required Skills and Experience
5+ years of experience in healthcare quality measurement, healthcare data integration, clinical analytics, or healthcare technology implementation. All relevant experience including work, education, transferable skills, and military experience will be considered.
Experience working with HEDIS® measurement programs, including measures that require clinical data or supplemental data sources.
Strong understanding of healthcare interoperability frameworks, including EHR data structures, HL7 messaging, and FHIR-based data exchange.
Experience working with large healthcare datasets and validating clinical data for regulatory reporting or quality measurement.
Demonstrated ability to manage complex cross-functional projects involving clinical teams, data teams, IT, and external partners.
Strong analytical and problem-solving skills with the ability to translate regulatory and technical requirements into operational workflows.
Excellent communication skills with the ability to work effectively with technical and non-technical stakeholders.
High school diploma (or equivalency) and legal authorization to work in the U.S.
Preferred Skills and Experience
Bachelor's or master's degree in healthcare administration, public health, informatics, data science, business, or a related field.
Experience implementing digital quality measurement initiatives, including HEDIS® ECDS measures or
Benefits
Health insuranceVision insurance
Additional Information
About Blue Cross and Blue Shield of Minnesota
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.
The Impact You Will Have
The ECDS & Digital Transformation Program Manager plays a key role in advancing BCBSMN's digital quality transformation by operationalizing HEDIS® Electronic Clinical Data Systems (ECDS) capabilities across all lines of business. Reporting to the Manager of HEDIS®, this role is responsible for translating digital quality strategy into day-to-day execution, ensuring that clinical data from electronic health records (EHRs), health information exchanges (HIEs), registries, and other digital sources can be reliably captured, validated, and used for HEDIS® measurement and reporting.
This role supports BCBSMN's transition from traditional claims-based and manual chart review processes toward scalable, digital-first quality measurement. The ECDS & Digital Transformation Program Manager partners closely with Quality Analytics, IT, Provider Relations, Clinical Operations, and external vendors to design and implement data pipelines, optimize clinical workflows for structured data capture, and ensure compliance with evolving NCQA and CMS digital quality requirements. Success in this role directly contributes to improved data accuracy, reduced administrative burden, and enhanced readiness for the evolving digital measurement environment. By operationalizing digital quality reporting capabilities, the ECDS & Digital Transformation Program Manager enables BCBSMN to scale quality measurement across lines of business and leverage clinical data more effectively for quality improvement, regulatory reporting, and enterprise performance management.
Bcbsmn · Eagan, MN