Senior Product Manager / Engineer - HEDIS SME

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Healthcare payer organizations are under immense pressure to improve outcomes and reduce the cost of providing coverage for patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Huron is seeking a Senior Product Engineer / Principal to join our HDTx Payer Services team, supporting healthcare payer clients in advancing data quality, regulatory reporting, and analytics capabilities. This role will operate at the intersection of business engagement, product engineering, and healthcare data strategy, with an initial focus on data quality and HEDIS reporting, evolving into predictive analytics and STARs performance optimization.

This individual will serve as a subject matter expert and trusted advisor, working closely with payer leadership, business stakeholders, and technical teams to deliver scalable, high-impact solutions.

Key Responsibilities
Data Quality & Reporting (Initial Focus)
Lead data quality initiatives impacting HEDIS, CMS submissions, and regulatory reporting accuracy
Assess, identify, and resolve data gaps, inconsistencies, and lineage issues across payer systems
Drive improvements in data validation, reconciliation, and reporting processes to ensure compliance and performance accuracy
Partner with stakeholders to define and implement data governance frameworks and standards
Serve as SME for HEDIS measures and CMS STARs rating methodologies, ensuring alignment of reporting and performance strategies
Translate complex regulatory requirements into functional and technical specifications
Support measurement strategy, performance monitoring, and reporting optimization to improve STARs outcomes
Provide advisory support to payer clients on CMS data submission and reporting best practices
Lead 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 systems
Collaborate with engineering teams to deliver scalable reporting and analytics products
Develop and implement predictive models and analytics frameworks to improve quality outcomes and STARs performance
Enable advanced analytics capabilities using payer data to identify trends, risks, and opportunities
Evolve reporting solutions into forward-looking, insights-driven platforms
Engage directly with business and executive stakeholders, acting as a strategic advisor
Translate business needs into technical roadmaps and product solutions
Lead or contribute to client-facing discussions, workshops, and design sessions
Collaborate across multi-disciplinary teams (data, IT, compliance, business operations)

Qualifications
Required
7–12+ years of healthcare payer experience, with strong domain 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 lifecycle, validation, and reconciliation processes

Proven ability to engage business stakeholders and translate requirements into solutions
Experience working in client-facing consulting or product engineering environments
Strong communication skills with ability to interface across technical and non-technical teams

Preferred
Hands-on experience with: Hedis Reporting SME
Cognizant CMS Edge Server
Claimsphere
Facets (TriZetto) or similar payer platforms

Experience with predictive analytics / data science applications in healthcare
Background in risk adjustment, quality improvement, or value-based care programs
SQL, data modeling, or advanced analytics tool experience
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Position Level
Consultant

Country
United States of America