Clinical Quality & Performance Leader

Blue Zones Health; California (MO); On-site; USD 115,000 - 145,000; Full time

Job summary

Blue Zones Health seeks a Quality Manager, Clinical Performance to lead operational quality efforts within our Well-Being Services Organization. You will oversee HEDIS/Stars reporting, care-gap identification and closure, and provider quality enablement.

Work with VP Well-Being Services, Medical Directors, and IT teams to embed quality into care delivery and pre-visit workflows, driving outcomes and adherence to quality standards.

Qualifications

• Bachelor's degree in nursing, healthcare administration, public health, health information management, or a related field.
• Significant experience in clinical quality, HEDIS, Stars, population health, value-based care, or health plan quality operations.
• Strong working knowledge of HEDIS measure specifications, CMS quality requirements, and clinical quality measurement.
• Experience managing care-gap identification and closure programs.
• Demonstrated ability to translate measure specifications into operational workflows.

Responsibilities

• Lead the operational quality function across health plan partnerships, providers, and member populations.
• Translate HEDIS, Stars, CMS, and health plan quality requirements into measurable priorities and workflows.
• Establish performance goals, dashboards, and accountability for quality measures.
• Identify underperformance and develop targeted improvement strategies with clinical and operational leaders.
• Maintain a line of sight between quality initiatives and member outcomes.

Skills

Clinical quality

HEDIS knowledge

Stars programs

Population health

Data analysis

Project management

Cross-functional leadership

Provider collaboration

Quality improvement

Education

Bachelor's degree in nursing or related field

RN/LPN/RHIA/RHIT/CPHQ credentials

Tools

Medi­care/HEDIS measurement software

Quality dashboards/tools

Job description

Blue Zones Health seeks a Quality Manager, Clinical Performance to lead operational quality efforts within our Well-Being Services Organization. You will oversee HEDIS/Stars reporting, care-gap identification and closure, and provider quality enablement.

Work with VP Well-Being Services, Medical Directors, and IT teams to embed quality into care delivery and pre-visit workflows, driving outcomes and adherence to quality standards.