Quality Manager
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Quality Manager leading quality performance strategy across MSSP ACO and Medicare Advantage. Managing quality measurement and engagement with healthcare practices for better patient outcomes.
Responsibilities:
- Own end-to-end quality performance, including measurement, monitoring, reporting, and submission processes to ensure we meet or exceed all contractual quality thresholds.
- Design and implement strategic initiatives focused on improving outcomes in preventive care and optimizing Stellar processes and workflows.
- Own relationships with external vendors and partners who support/advise on the quality submission processes.
- Advise ACO leadership on performance trends, identify opportunities for improvement, and contribute to setting cost and quality contract targets.
- Establish and track key performance indicators (KPIs) to measure the impact of interventions and guide future strategy.
- Serve as the subject matter expert on CMS and payer quality programs (MSSP, Medicare Stars, MIPS, HEDIS, eCQMs), translating complex requirements into actionable workflows.
- Manage all supplemental data submission workflows, including chart retrieval, data integrity checks, and validation audits.
- Lead primary source verification (PSV) audit protocols, partnering with practices to ensure chart-level compliance with NCQA standards.
- Work directly with network practices to co-design workflows that optimize quality performance, providing hands-on training and education on best practices.
- Collaborate across internal teams (Product, Analytics, and Operations) to build scalable, consistent data workflows and provider-facing tools.
Requirements:
- 6+ years of experience in healthcare, with a strong focus on Medicare and/or Medicare Advantage.
- 4+ years of direct experience in healthcare quality, including hands-on management of end-to-end quality submissions for an ACO or health plan.
- Proven success developing and implementing quality initiatives that measurably improve health outcomes and exceed industry benchmarks.
- Expert-level knowledge of HEDIS, MIPS, and MSSP ACO quality reporting requirements.
- A Bachelor’s degree in Healthcare, Public Health, or a related field.
- Preferred Qualifications: Clinical background (RN, LPN, MA). Experience in a fast-paced startup environment. Background in Process Improvement methodologies.
Benefits:
- Medical, Dental and Vision Benefits
- Flexible PTO
- Universal Paid Family Leave
- Company sponsored One Medical memberships and Citibike memberships
- Medical Travel Benefits
- A monthly wellness stipend that gives employees the freedom to choose where they spend their cash, whether it be on wellness, pet care, childcare, WFH items, or charitable donations
- Stock Options & a 401k matching program
- Career development opportunities like Manager Training, coaching, and an internal mobility program
- A broad calendar of company sponsored social events that for our in-office and remote employees
Similar Jobs
Senior Manager, Internal Audit
Senior Manager for Internal Audit at City of Hope, overseeing the internal audit program and collaborating with executives. Engaging with risks and ensuring governance in a healthcare environment.
Professional Services Manager
Professional Services Manager delivering automation solutions with a hands-on approach in security operations. Leading and mentoring a team while ensuring customer satisfaction and delivery quality.
Senior Commercial Excellence Manager, Stroke
Senior Commercial Excellence Manager supporting revenue growth for thrombectomy medical device business at Imperative Care. Leading sales planning, forecasting, and compensation strategies within commercial operations.
Senior Quality Manager
Senior Quality Manager overseeing Quality department at Cristcot focusing on regulatory compliance and product quality. Collaborating with multiple teams and managing quality systems to ensure efficiency.
Senior Living Revenue Manager
Regional Revenue Senior Living Manager managing billing operations and credentialing processes at Tutera Senior Living & Health Care. Seeking energetic individuals dedicated to compassion and excellence in senior living.
General Manager – Lending
General Manager leading Clasp's student lending business for university partnerships and compliance. Overseeing P&L and operational integrity for a fintech startup, emphasizing performance and regulatory standards.
Senior Manager, Commercial Excellence
Senior Manager, Commercial Excellence at Saluda Medical designing and delivering sales training programs. Collaborating with sales leadership and marketing to enhance field sales effectiveness in neurostimulation.
Customer Manager – 12-month fixed-term
Customer Manager driving commercial excellence and growth across key customer accounts for Clorox in Canada. Focus on account management, strategic planning, and customer partnerships.
Senior New Business Case Manager
Senior New Business Case Manager I at Pacific Life reviewing new business applications for completeness and compliance. Collaborating with Financial Professionals for efficient application processing.
City Manager Immobilier – Conciergerie
City Manager role at ALB Conciergerie managing short-term rentals in France. Focus on property management and client relationships in a flexible work environment.
City Property Manager
City Manager in national concierge network managing short-term rentals. Engaging with property owners for effective management across various locations.
Branch Manager
Branch Manager overseeing day-to-day sales operations in Indianapolis, focusing on performance and team management. Collaborating with senior leadership to achieve operational goals and service quality.
RCM Referral & Eligibility Manager
Referral & Eligibility Manager overseeing eligibility verification and authorization procurement activities for service lines. Managing team production, quality, and resolving issues within compliance standards.
Total Rewards Manager – Executive Compensation
Total Rewards Manager focusing on executive compensation strategies at Supercell. Partnering with leadership to evolve pay design and ensuring competitive practices globally.
Bioinformatics Team Manager
Bioinformatics Team Manager leading a senior team at DNAstack to shape bioinformatics function. Collaborating with product and engineering leadership to define the bioinformatics roadmap.
Manager – Sustainability Consulting
Manager for Sustainability Consulting at a Climate Tech Start-up supporting companies in emission reduction. Focus on carbon management and team leadership in a remote setup.
Offering Manager
PS Offering Manager managing Fortinet professional services portfolio for Exclusive Networks. Driving sales integration and vendor relationships for a global cybersecurity specialist.
PS Offering Manager
Offerings Manager overseeing Palo Alto Networks professional services portfolio management. Driving sales transformation and managing compliance as part of Exclusive Networks’ global services offering.
Offering Manager
PS Offering Manager responsible for Fortinet Networks professional services at Exclusive Networks. Leading product management, vendor relationships, and sales integration globally.
Payments Operations Manager
Payments Operations Manager leading operational excellence within Conduent's Payment Services Group. Requires strong experience in financial services and leadership skills.