Quality Improvement Manager — Clinical Oversight

Blehealth,-LLC; Pomona (CA); On-site; USD 110,000 - 170,000; Full time

Job summary

BLEHEALTH is seeking a QI Manager to lead Quality Improvement, Performance Improvement, Compliance, Risk Management, Patient Safety, and Care Management. You will collaborate with the RN Clinical Director to ensure clinical accuracy, documentation quality, and continuous improvement in member outcomes.

This role drives regulatory readiness for audits and accreditation, oversees chart reviews and care plan validation, and supports staff through QI tools and training to close care gaps.

Qualifications

• 4+ years of recent experience in quality improvement, performance improvement, risk management, or clinical oversight in acute care, home health, primary care, or managed care.
• High-level knowledge of Home Health, Case Management, UDS & HEDIS, CalAIM, CDPH, CMS, and MediCal regulations.
• Excellent written and verbal communication skills.
• Intermediate proficiency in Microsoft Office; advanced Excel skills required.
• Ability to supervise and direct professional and administrative personnel.
• Participation in Quality Assurance/Performance Improvement programs.

Responsibilities

• Lead development, implementation, and evaluation of BLEHEALTH’s Performance Improvement Program.
• Ensure member charts are complete, compliant, and audit-ready by collaborating with care managers and coordinators.
• Oversee documentation quality and regulatory compliance across charts and care plans.
• Provide clinical guidance on documentation quality, care gap closure, and regulatory requirements.
• Collaborate with staff to correct deficiencies and drive continuous improvement in documentation practices.
• Develop and maintain the QI work plan, reporting calendar, and performance metrics.

Skills

QI leadership

Communication skills

Excel (advanced)

Staff supervision

Regulatory knowledge

Education

Master’s degree in Public Health/Healthcare Admin

Bachelor’s degree + relevant experience

Tools

Excel (advanced)

Microsoft Office

Job description

BLEHEALTH is seeking a QI Manager to lead Quality Improvement, Performance Improvement, Compliance, Risk Management, Patient Safety, and Care Management. You will collaborate with the RN Clinical Director to ensure clinical accuracy, documentation quality, and continuous improvement in member outcomes.

This role drives regulatory readiness for audits and accreditation, oversees chart reviews and care plan validation, and supports staff through QI tools and training to close care gaps.