Remote NJ Quality & Compliance Lead

Abound Health; New Jersey; Remote; USD 60,000 - 65,000; Full time

Benefits offered by this job

Benefits package

Health/dental coverage

401(k) eligibility after 12 months

Job summary

Abound Health in New Jersey is seeking a Quality Manager to lead day-to-day quality, regulatory, payer, and contract compliance programs across New Jersey operations. The role reports to the EVP of Quality & Compliance and collaborates with operations, clinical, finance, HR, and legal to ensure adherence to state and federal requirements.

This is a remote role for NJ residents. The ideal candidate brings 5+ years of healthcare quality/compliance experience, NJ DDD or Medicaid familiarity, and

Qualifications

• 5+ years of progressive experience in healthcare quality/compliance.
• Direct experience with payer requirements, contract compliance, and incident reporting.
• Experience with New Jersey DDD, Medicaid Waiver, or NJ FamilyCare preferred.
• Ability to interpret contracts and translate requirements into processes.

Responsibilities

• Lead NJ-specific quality and compliance priorities, workplans, and operating processes.
• Partner with operations and clinical teams to embed quality and compliance into daily operations, onboarding, supervision, and service delivery.
• Oversee payer audit preparation and responses, including medical records requests and pre/post-payment reviews.
• Develop and monitor Plans of Correction following investigations.
• Coordinate accreditation and external reviews as applicable.
• Design and execute NJ audit and monitoring plans covering documentation, authorizations, contract deliverables, incidents, credentials, and billing support.
• Establish and monitor quality and compliance dashboards and KPIs.
• Provide routine reporting to leadership and elevate material risks and trends.

Skills

Quality compliance

Regulatory knowledge

Project management

Healthcare experience

Cross-functional collaboration

Education

Bachelor's degree in healthcare/related field

Master’s degree preferred

Job description

Abound Health in New Jersey is seeking a Quality Manager to lead day-to-day quality, regulatory, payer, and contract compliance programs across New Jersey operations. The role reports to the EVP of Quality & Compliance and collaborates with operations, clinical, finance, HR, and legal to ensure adherence to state and federal requirements.

This is a remote role for NJ residents. The ideal candidate brings 5+ years of healthcare quality/compliance experience, NJ DDD or Medicaid familiarity, and