ACO Quality Manager — Nurse Leader Driving CMS Quality

Provider-Partners-Health-Plan-; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Provider-Partners-Health-Plan- is seeking an experienced ACO Quality Manager (RN) to support quality performance across Medicare accountable care programs, including MSSP, ACO REACH, and LEAD. The role blends clinical expertise, data analysis, and education to close care gaps and improve outcomes.

The ideal candidate will review data, perform medical-record audits, and collaborate with providers to translate CMS requirements into practical training and actionable improvements.

Qualifications

• Active and unrestricted Registered Nurse license.
• BSN or equivalent nursing education.
• Experience with Medicare MSSP/ACOs and value-based care.
• Knowledge of CMS quality measures and reporting methodologies.
• Experience conducting medical-record audits and chart abstraction.
• Experience delivering education to physicians and nurses.
• Experience creating training across live, virtual, and e-learning.
• Strong communication and presentation skills.
• Proficiency with EHRs, population health platforms, Excel, and quality tools.
• Attention to detail and regulatory knowledge.

Responsibilities

• Monitor MSSP, ACO REACH, LEAD and CMS quality measures.
• Interpret quality-measure specifications and CMS guidance.
• Analyze clinical, claims, pharmacy, lab data to identify gaps.
• Conduct medical-record audits to validate documentation.
• Provide feedback to providers and clinical staff.
• Develop and deliver training programs across live, virtual, and e-learning platforms.
• Track corrective actions and follow-up from audits.
• Maintain knowledge of CMS accountable care models and deadlines.

Skills

Clinical data interpretation

Chart abstraction

Quality reporting

Provider education

Training program development

Presentation skills

CMS measures

Cross-functional collaboration

Regulatory interpretation

Education

BSN or equivalent

RN license

Tools

Power BI

Tableau

SQL

Excel

Job description

Provider-Partners-Health-Plan- is seeking an experienced ACO Quality Manager (RN) to support quality performance across Medicare accountable care programs, including MSSP, ACO REACH, and LEAD. The role blends clinical expertise, data analysis, and education to close care gaps and improve outcomes.

The ideal candidate will review data, perform medical-record audits, and collaborate with providers to translate CMS requirements into practical training and actionable improvements.