NJ Quality & Compliance Manager - Remote

Abound Health; United States; Remote; USD 60,000 - 65,000; Full time

Benefits offered by this job

Health insurance

Dental coverage

Wellness program

401(k) eligibility

Job summary

Abound Health is seeking a Quality Manager to lead the day-to-day execution of quality, regulatory, payer, and contract compliance programs across New Jersey operations. This remote role will coordinate with clinical, finance, billing, HR and legal teams to ensure state and federal compliance, payer policies, and contractual obligations.

Reporting to the EVP of Quality & Compliance, you will guide NJ-specific priorities, monitor audits, and drive corrective actions while embedding quality into

Qualifications

• Bachelor's degree in Healthcare Administration, Business, Nursing, Social Work, Public Health, Quality/Compliance or related field.
• 5 years of progressive experience in healthcare quality/compliance.
• Direct experience with payer requirements, contract compliance and incident reporting in a regulated environment.
• Experience in behavioral health/IDD/HCBS or similar setting preferred.
• Knowledge of NJ DDD Medicaid Waiver or NJ FamilyCare requirements strongly preferred.

Responsibilities

• Lead New Jersey quality and compliance priorities and workplans.
• Serve as NJ subject matter lead for quality, compliance, contract requirements and payer expectations.
• Embed quality and compliance into daily operations, onboarding and service delivery.
• Maintain knowledge of NJ DDD requirements and translate into workflows and training.
• Oversee payer audit preparation and responses including medical record requests and reviews.
• Identify and resolve potential overpayments.
• Oversee NJ incident management, investigations, and root cause analysis.
• Develop and monitor Plans of Correction after investigations.
• Coordinate accreditation and external reviews as applicable.
• Design and execute NJ audit and monitoring plans across documentation and billing support.
• Establish and monitor quality dashboards and KPIs.
• Provide routine reporting to leadership and flag material risks.

Skills

Communication

Collaboration

Project management

Analytical skills

Education

Bachelor's degree in Healthcare Administration

Master's degree preferred

Job description

Abound Health is seeking a Quality Manager to lead the day-to-day execution of quality, regulatory, payer, and contract compliance programs across New Jersey operations. This remote role will coordinate with clinical, finance, billing, HR and legal teams to ensure state and federal compliance, payer policies, and contractual obligations.

Reporting to the EVP of Quality & Compliance, you will guide NJ-specific priorities, monitor audits, and drive corrective actions while embedding quality into