RN – Value-Based ACO Quality Manager

Provider Partners Health Plan; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Provider Partners Health Plan seeks an experienced ACO Quality Manager (RN) to oversee quality performance across Medicare accountable care programs, including MSSP, ACO REACH, and LEAD. You will analyze clinical/claims data, audit records, and collaborate with providers to close gaps in documentation and care outcomes.

The role requires strong knowledge of CMS quality measures and the ability to translate complex requirements into practical education and training across live and digital

Qualifications

• Active and unrestricted RN license with BSN or equivalent.
• Experience with Medicare MSSP/ACO models or value-based care.
• Proficiency in CMS quality measures and documentation requirements.

Responsibilities

• Monitor MSSP/ACO quality measures and CMS reporting requirements.
• Conduct medical-record audits to validate measure compliance.
• Interpret measure specifications and CMS guidance for teams.
• Develop and deliver training across live, virtual, and e-learning formats.
• Provide actionable feedback to physicians and clinical staff.

Skills

RN license

BSN

Quality-measure knowledge

Medical-record auditing

Data analysis

Provider education

Training program development

CMS quality requirements

Quality-performance reporting

Communication skills

Presentation skills

HIPAA compliance

Cross-functional collaboration

Train-the-trainer delivery

Detail orientation

Problem solving

Power BI

Tableau

SQL

Education

BSN or equivalent nursing degree

Active and unrestricted nursing license

Experience with Medicare MSSP/ACO models

Tools

Power BI

Tableau

SQL

Electronic Health Records (EHR) systems

Job description

Provider Partners Health Plan seeks an experienced ACO Quality Manager (RN) to oversee quality performance across Medicare accountable care programs, including MSSP, ACO REACH, and LEAD. You will analyze clinical/claims data, audit records, and collaborate with providers to close gaps in documentation and care outcomes.

The role requires strong knowledge of CMS quality measures and the ability to translate complex requirements into practical education and training across live and digital