Healthcare Data Quality Lead

Classification: Exempt

Reports To: Director of Clinical Informatics

Company Overview

MyHealth Access Network is a 501(c)(3) non-profit statewide Health Information Exchange (HIE) that provides cutting-edge technology solutions to improve patient care by facilitating collaboration between providers. We coordinate care across various agencies, supporting not only physical health but also addressing social determinants of health. Our commitment to the 5 rights of health information—right patient, right provider, right information, at the right time, in the right setting—ensures better patient outcomes while safeguarding individual privacy.

Job Overview

MyHealth Access Network is seeking a highly experienced individual to serve as program owner for NCQA Data Aggregator Validation (DAV) readiness, overseeing governance, documentation, data quality processes, technical workflows, and cross-functional coordination required to successfully achieve and maintain NCQA DAV status.

This individual will act as the bridge between clinical informatics, analytics, IT, quality, compliance, and external partners, ensuring that MyHealth’s data aggregation processes meet NCQA standards for accuracy, traceability, and auditability across clinical and claims data.

Key Responsibilities Include:

  • Serve as MyHealth’s internal DAV program lead, accountable for readiness, execution, and ongoing compliance
  • Lead a comprehensive internal gap assessment against NCQA DAV standards and scoring criteria
  • Develop and manage the DAV readiness roadmap, including timelines, dependencies, and risk mitigation strategies
  • Coordinate preparation for NCQA submission, virtual review, and audit activities

Governance, Documentation & Audit Readiness

  • Establish and maintain DAV-aligned governance frameworks, including policies, SOPs, and decision logs
  • Ensure documentation reflects real-world operational practices, not aspirational workflows
  • Coordinate and curate DAV-required documentation, including:
    • Data flow diagrams
    • Source system inventories
    • Data lineage and transformation logic
    • Quality assurance and validation processes
    • Version control and change management evidence

Data Quality & Validation

  • Define and operationalize data quality standards aligned with NCQA expectations
  • Ensure data traceability from source → ingestion → transformation → analytics output
  • Partner with analytics and informatics teams to resolve data anomalies, provenance gaps, and edge cases
  • Apply and map standardized coding systems such as ICD-10, CPT, LOINC, and SNOMED across disparate source systems.
  • Validate data quality and completeness from FHIR APIs, HL7 v2.x interfaces, EHRs, and payer feeds using USCDI-aligned schemas.

Cross-Functional & Vendor Coordination

  • Act as the central point of coordination between:
    • Clinical Informatics
    • Data & Analytics
    • IT / Engineering
    • Compliance & Privacy
    • Client Services
    • Portal and analytics vendors
  • Translate NCQA standards into clear, actionable requirements for technical and operational teams
  • Manage dependencies with external vendors supporting ingestion, analytics, and reporting platforms

Stakeholder Communication & Reporting

  • Provide regular updates on readiness status, risks, and mitigation strategies
  • Prepare leadership for NCQA interactions, including mock reviews and audit scenarios
  • Serve as MyHealth’s subject matter expert for DAV-related inquiries from payers, providers, and partners

Sustainability & Continuous Compliance

  • Design processes to sustain DAV compliance post-validation, including:
    • Ongoing monitoring
    • Change impact assessments
    • Annual updates and revalidation readiness
  • Align DAV processes with broader organizational initiatives (value-based care, quality reporting, population health)

Required Qualifications

Experience

  • 7+ years of experience in healthcare data, quality measurement, analytics, or health IT
  • Direct experience with one or more of the following:
    • NCQA Data Aggregator Validation (DAV)
    • NCQA HEDIS, PSV, or audit programs
    • Quality reporting using aggregated clinical and/or claims data
  • Demonstrated experience leading audit or certification readiness programs (NCQA, CMS, HITRUST, SOC, etc.)

Technical & Domain Expertise

  • Strong understanding of:
    • Health Information Exchanges (HIEs)
    • Clinical data standards (HL7 v2, CCD/C-CDA, FHIR)
    • Claims data structures and use in quality measurement
    • Data lineage, ETL processes, and analytics workflows
  • Ability to assess and explain data provenance, transformation logic, and validation controls to both technical and non-technical audiences

Leadership & Program Management

  • Proven ability to lead complex, cross-functional initiatives
  • Exceptional organizational and documentation skills
  • Comfortable operating in ambiguity and translating standards into operational reality

Preferred Qualifications

  • Prior experience working within or with a statewide HIE
  • Experience supporting value-based care, Medicaid managed care, or payer quality programs
  • Familiarity with NCQA scoring methodology and validation decisioning
  • PMP, CPHQ, or similar certification (preferred, not required)

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit; stand; walk; use hands to finger, handle or feel; and reach with hands and arms. The employee is required to lift a maximum of 30 pounds.

Position Type/Expected Hours of Work

This is a remote position. The employee must have a private location from which to work, with Internet access and a personal smartphone with capability to be secured and have support for SMS, apps for multifactor authentication and remote hotspot (technology stipend provided to help offset costs). Some flexibility in hours is allowed, but the employee must be available during the “core” work hours of 8:30 a.m. to 5 p.m. CST. and must work 40 hours each week to maintain full-time status.

Work Environment

This job operates in a professional virtual office environment (Remote). This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, fax machines, paper binders and paper cutters.

While performing the duties of this job, the employee is regularly required to read (see), talk and hear. The employee frequently is required to sit; stand; walk; use hands to finger, handle or feel; and reach with hands and arms. The employee is required to lift a maximum of 30 pounds.

Travel

Occasional travel may be required in support of on-site meetings, projects and customers, primarily local and statewide.

AAP/EEO Statement

MyHealth expressly prohibits any form of unlawful employee harassment based on race, color, religion, gender, sexual orientation, national origin, age, genetic information, disability or veteran status.

Other Duties

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. The following are always expected:

  • Comply with employee handbook
  • Be prompt and on time
  • Communicate clearly
  • Treat others with respect
  • Maintain confidentiality where appropriate
  • Be honest and open with questions, concerns and feedback for others