Quality Improvement & Compliance Leader

BLEHEALTH; Pomona (CA); On-site; USD 110,000 - 160,000; Full time

Job summary

BLEHEALTH is seeking a QI Manager to lead quality improvement, performance improvement, risk management, patient safety, and care management quality functions. You will partner with clinical leadership to ensure accuracy, care gap closure, and continuous improvement in member outcomes.

The role supports audits, regulatory compliance, and health plan requirements, reviewing charts and care plans to prevent avoidable hospitalizations through proactive interventions.

Qualifications

• 4+ years of quality improvement, performance improvement, risk management or clinical oversight experience in acute care, home health, primary care, or managed care settings.
• Strong regulatory knowledge across CDPH, CMS, Medi-Cal, CalAIM and accreditation programs.
• Excellent written and verbal communication skills; capable of supervising professional and administrative staff.
• Ability to translate data into actionable improvement plans and present to leadership.

Responsibilities

• Lead development, implementation, and evaluation of BLEHEALTH’s Quality Improvement Program.
• Ensure charts and documentation are complete, compliant, and audit-ready.
• Provide clinical guidance on documentation quality and regulatory requirements.
• Oversee risk management, patient safety, and incident investigations.
• Coordinate care-gap closure and ensure timely interventions to prevent hospitalizations.
• Lead cross-functional teams to drive continuous improvement using QI methodologies.
• Prepare reports and dashboards for internal leadership and external partners.
• Support regulatory audits and readiness activities with documentation and corrective actions.

Skills

Quality Improvement

Regulatory Knowledge

Leadership

Data Analysis

Communication

Project Management

Education

Master’s degree in Public Health or Healthcare Administration (or related)

Bachelor’s degree + 2–3 years relevant experience

Tools

Microsoft Office

Excel

Job description

BLEHEALTH is seeking a QI Manager to lead quality improvement, performance improvement, risk management, patient safety, and care management quality functions. You will partner with clinical leadership to ensure accuracy, care gap closure, and continuous improvement in member outcomes.

The role supports audits, regulatory compliance, and health plan requirements, reviewing charts and care plans to prevent avoidable hospitalizations through proactive interventions.