Remote Health Plan Quality & Performance Manager HEDIS NCQA

Jobgether; Lake Michigan Beach (MI); Remote; USD 66,000 - 130,000; Full time

Benefits offered by this job

Remote work in Michigan

Full-time employment

Professional development

Job summary

Jobgether is seeking a Health Plan Quality Program Management & Performance Manager based in the United States. The role focuses on leading quality initiatives, ensuring NCQA and HEDIS compliance, and coordinating audits and accreditation activities.

The candidate will monitor performance, translate regulatory requirements into program plans, and collaborate with quality leadership to strengthen outcomes. Remote work is available for Michigan-based professionals with Medicaid/managed care

Qualifications

• At least 6 years of healthcare experience, including 4+ years in health plan quality improvement.
• Strong knowledge of HEDIS and NCQA standards.
• Experience managing quality improvement deliverables with regulators.

Responsibilities

• Lead quality program management to ensure compliance with state and federal regulations and NCQA.
• Provide guidance for quality-related projects and initiatives.
• Plan and maintain quality improvement activities meeting regulatory requirements.
• Prepare documentation for quality committees and meetings.
• Oversee audits, accreditation surveys, and NCQA activities.
• Monitor key quality deliverables and present findings to leadership.
• Prepare narrative reports and translate regulations into actions.
• Maintain quality program management plans documenting requirements.
• Collaborate with state and national leaders to update policies.
• Create, manage, and compile documentation supporting quality activities.
• Lead quality improvement meetings and cross-functional discussions.
• Evaluate program activities for improvements and corrective actions.
• Partner with leadership to address escalations and compliance gaps.
• Provide training and support to team members.
• Travel 0–50% same-day and 0–20% overnight as needed.

Skills

Healthcare quality

Data analysis

Regulatory understanding

Project management

Stakeholder communication

Education

Healthcare-related degree preferred

Tools

Excel

Job description

Jobgether is seeking a Health Plan Quality Program Management & Performance Manager based in the United States. The role focuses on leading quality initiatives, ensuring NCQA and HEDIS compliance, and coordinating audits and accreditation activities.

The candidate will monitor performance, translate regulatory requirements into program plans, and collaborate with quality leadership to strengthen outcomes. Remote work is available for Michigan-based professionals with Medicaid/managed care