Health Plan Quality Program Management & Performance Manager (Fully Remote)

Partner Company; United States; Remote; USD 70,000 - 110,000; Full time

Benefits offered by this job

Remote work

Job summary

Partner Company in the United States seeks a Quality Improvement professional to ensure health plan programs comply with state, federal, and NCQA regulations. You will plan, implement, and maintain quality improvement activities that meet reporting requirements and drive measurable outcomes.

The role involves audits, accreditation surveys, and training the quality management team. You will collaborate with quality leadership to close escalations and improve compliance, with a remote work setup

Responsibilities

• Ensure health plan programs comply with state, federal, and NCQA regulations.
• Plan, implement, and maintain quality improvement activities that meet reporting requirements.
• Prepare for audits, accreditation surveys, and quality improvement reports.
• Monitor key deliverables to ensure accuracy and on-time completion.
• Partner with quality leadership to investigate escalations and resolve compliance gaps.
• Provide training and guidance to quality management team members.

Job description

• Ensure health plan programs comply with state, federal, and NCQA regulations.
• Plan, implement, and maintain quality improvement activities that meet reporting requirements.

Performance Monitoring and Audits:

• Prepare for audits, accreditation surveys, and quality improvement reports.
• Monitor key deliverables to ensure accuracy and on-time completion.

Collaboration and Improvement:

• Partner with quality leadership to investigate escalations and resolve compliance gaps.
• Provide training and guidance to quality management team members.

Partner Company

This organization partners with health plans to implement quality improvement programs and ensure compliance with regulatory standards such as NCQA and HEDIS. The culture emphasizes collaboration, regulatory excellence, and continuous improvement, with a remote work environment for professionals based in Michigan.