Senior Manager - Healthcare Quality & Process Excellence

Sagility; Philippines; On-site; PHP 1,800,000 - 2,600,000; Full time

Job summary

Sagility is seeking a Senior Manager Business Excellence - Quality to lead and govern quality programs across Clinical Operations. The role focuses on monitoring channels, driving data-driven improvements, and ensuring regulatory alignment with NCQA, CMS, and URAC standards.

The role requires leadership of Quality Managers and auditors, along with collaboration across Operations, Training, and Medical Directors to deliver sustainable quality outcomes.

Qualifications

• Registered Nurse (RN) preferred.
• Experience supporting healthcare payer operations, utilization management, care management, prior authorization, or appeals and grievances.
• Experience with NCQA, CMS, URAC, or other healthcare accreditation and regulatory standards.

Responsibilities

• Leads development and governance of quality assurance programs across Clinical operations.
• Monitors quality performance metrics, scorecards, and dashboards, and identifies trends and risks.
• Provides data-driven insights to support quality evaluations and client reporting.
• Drives continuous improvement through Lean, Six Sigma, Kaizen, and process optimization initiatives.
• Oversees clinical quality monitoring activities including utilization management, care management, and prior authorization.

Skills

RN preferred

Healthcare payer operations

Quality assurance

Regulatory standards

Data-driven analysis

Job description

Sagility is seeking a Senior Manager Business Excellence - Quality to lead and govern quality programs across Clinical Operations. The role focuses on monitoring channels, driving data-driven improvements, and ensuring regulatory alignment with NCQA, CMS, and URAC standards.

The role requires leadership of Quality Managers and auditors, along with collaboration across Operations, Training, and Medical Directors to deliver sustainable quality outcomes.