Quality Assurance Leader — Hybrid CA

Pacific Health Group; Northern (KY); Hybrid; USD 78,000 - 82,000; Full time

Benefits offered by this job

PTO

Paid Holidays

401(k) with company match

Hybrid work environment

Job summary

Pacific Health Group is seeking a QA Manager to lead the organization-wide Quality Assurance program, oversee audits, and drive continuous improvement across ECM, CS, CHW services, and clinical operations.

The role requires strategic oversight of documentation, processes, and compliance with payer and regulatory requirements, plus supervision of QA staff and collaboration with department leaders.

Qualifications

• Bachelor's degree or higher in a related field.
• Minimum four (4) years of progressive experience in quality assurance, auditing, healthcare operations, managed care, or related environment.
• Minimum two (2) years of leadership, supervisory, or quality team oversight experience.
• Demonstrated experience conducting audits and evaluating documentation, workflows, and operational quality.
• Strong understanding of healthcare quality assurance principles, documentation standards, quality monitoring, and process improvement methodologies.
• Experience developing corrective action plans and monitoring improvement through resolution.

Responsibilities

• Lead the QA program development, implementation, and continuous improvement across PHG programs and departments.
• Establish standardized quality expectations, audit methodologies, monitoring processes, scoring criteria, and reporting requirements.
• Develop annual and ongoing quality monitoring plans based on priorities, payer requirements, risks, findings, and trends.
• Ensure QA processes are consistently applied across applicable programs and departments.
• Maintain Quality Assurance policies, procedures, tools, checklists, workflows, and SOPs.
• Coordinate preparation for external audits and reviews; maintain readiness and timely submissions.
• Monitor QA metrics, dashboards, and trends; escalate significant risks to Directors.

Skills

Leadership

Auditing

Quality improvement

Documentation standards

Education

Bachelor's degree in Healthcare Administration, Public Health, Business Administration, Social Services, or related field

Tools

Microsoft Office Suite

Reporting tools

Workflow systems

Electronic documentation platforms

Job description

Pacific Health Group is seeking a QA Manager to lead the organization-wide Quality Assurance program, oversee audits, and drive continuous improvement across ECM, CS, CHW services, and clinical operations.

The role requires strategic oversight of documentation, processes, and compliance with payer and regulatory requirements, plus supervision of QA staff and collaboration with department leaders.