Senior Quality Practice Manager - WI Based Work from Home

Lakeland Care; Fond du Lac (WI); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading company in healthcare is seeking a Senior Quality Practice Manager to oversee quality initiatives and ensure compliance with DHS requirements. This role involves leading a team, managing quality assurance programs, and collaborating across departments to enhance service delivery and member outcomes. The ideal candidate will have a strong background in healthcare leadership and a commitment to improving health outcomes.

Qualifications

• 7 years of leadership experience in healthcare services or health insurance.
• Knowledge of federal rules and regulations of Medicaid benefits.

Responsibilities

• Lead integration and oversight of Quality Management Program.
• Manage risk and incident tracking, ensuring compliance.
• Support continuous learning and training across teams.

Skills

Leadership

Collaboration

Quality Assurance

Critical Thinking

Education

Bachelor’s degree in Healthcare Administration

Bachelor’s degree in Business

Bachelor’s degree in Nursing

Bachelor’s degree in Public Health

Bachelor’s degree in Social Work

Job description

Senior Quality Practice Manager - WI Based Work from Home

Join to apply for the Senior Quality Practice Manager - WI Based Work from Home role at Lakeland Care

Senior Quality Practice Manager - WI Based Work from Home

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Join to apply for the Senior Quality Practice Manager - WI Based Work from Home role at Lakeland Care

Description

Join our award winning culture as we support members in Wisconsin!

Position Summary

The Senior Quality Practice Manager (SQPM) leads the integration, implementation, and oversight of Lakeland Care’s Quality Management Program in alignment with the organization’s mission and the Department of Health Services (DHS) Family Care contract requirements. In addition, this role oversees the Best Practice team, which is responsible for identifying improvements to practice, training to competencies, and overall response to quality findings.

Description

Join our award winning culture as we support members in Wisconsin!

Position Summary

The Senior Quality Practice Manager (SQPM) leads the integration, implementation, and oversight of Lakeland Care’s Quality Management Program in alignment with the organization’s mission and the Department of Health Services (DHS) Family Care contract requirements. In addition, this role oversees the Best Practice team, which is responsible for identifying improvements to practice, training to competencies, and overall response to quality findings.

The SQPM works cross-functionally with other Program Operations Managers, including Provider Relations, and Care Management. teams to support excellence in service delivery, compliance, performance improvement, and member outcomes. This position supports and directs all Family Care quality initiatives, while continuously assessing new opportunities to improve health outcomes for the membership.

This position directs quality assurance and performance improvement initiatives, manages risk and incident tracking, and ensures that organizational policies reflect quality standards and contractual obligations. The SQPM will also support continuous learning, training, and coaching across teams to ensure a strong quality culture and sustained compliance. The SQPM ensures that tools, trainings, resources, and workflows reflect contractual expectations and current best practices, enabling staff to deliver consistent, person-centered care and accurate documentation.

Essential Competencies

Accountability

• Provide day-to-day leadership and management that mirrors the adopted mission, vision, and values of Lakeland Care.
• Solve problems with an outcome-based, solution-focused approach.
• Ensure policies related to safety and risk are appropriately developed, implemented and upheld throughout the organization.
• Support Annual Quality Review activities conducted on behalf of the DHS.
• Direct External Quality Review (EQR) preparation, documentation, and response strategies.
• Support the risk management process through the development of tools, evidence-based practices and policies to analyze, report and manage risk.
• Assists the Provider and CM Support Director in achieving strategic business and quality improvement goals.
  
  

Critical Thinking

• Translate DHS requirements and audit findings into actionable operational improvement
• Understand quality data analysis and interpretation. Share data in a meaningful way within the organization.
• Identify barriers and address problems cooperatively as they occur.
• Develop, monitor, and implement activities related to the annual Quality Management Plan. This includes updates to Senior Leadership on organizational progress.
• Assess Care Management practices for consistency and fidelity to Lakeland Care’s practice model, elevating opportunities for system-wide standardization and improvement.
  
  

Commitment to Excellence

• Handle high workloads, competing demands, vague assignments, interruptions, and distractions with poise and ease.
• Lead in the development, communication, and implementation of effective strategies and processes.
• Collaborate on the development of preventive and proactive tools and training that support service quality and member health outcomes
  
  

Interpersonal Awareness

• Demonstrate maturity and professionalism under pressure; handle sensitive situations with confidentiality and fairness.
• Guide others through change with empathy and clarity, reinforcing Lakeland Care’s values.
• Respect other opinions and concerns and value diversity in thought and action.
• Demonstrate honesty and transparency in all interactions and be authentically open to feedback.
• Foster a learning environment that encourages growth and reflective practice.
  
  

Relationship Building

• Demonstrate an ability to influence others through positive reinforcement, teamwork, and content knowledge.
• Motivate and lead a high-performance team.
• Guide project teams and execute work plans for strategic process redesign and performance.
• Provide leadership and guidance to Quality Division and ensure performance standards are met.
• Participate in strategic planning and development of operational plans for the Quality Division. Collaborate with leaders to develop vision and strategic plans to support business objectives and ensure productivity and services enhancements opportunities are identified, created, and implemented.
• Able to plan through strategic thinking and engage team members in this process.
• Actively mentor and grow leadership internally, as well as externally.
• Reach consensus about goals and methods for completing projects or tasks.
  
  

Organizational Regard

• Support Lakeland Care’s mission, vision, values, and strategic planning.
• Partner with the C-level executives and other senior leaders to accomplish short and long-term operational goals.
• Contribute to strategic planning and identify system-level improvements for quality, documentation, training, and risk mitigation.
• Manage and guide organizational quality committee activities.
• Represent LCI and obtain stakeholder feedback through meetings with various committees and professional associations.
• Build strong relationships with key stakeholders: government relations, business development, and other subject matter experts (SMEs) to gather and disseminate knowledge and ensure it is incorporated into request for proposal (RFP) responses, growth planning and product development efforts.
  
  

The duties listed above are typical for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.

Work Relationships And Scope

Report directly to the Provider and CM Support Director. Work closely with leaders and employees within the Organization. Direct reports include Quality Manager, Quality Risk Manager, and Best Practice Manager. Regular contact with outside agencies, Federal and State Agencies, legal counsel, professional service providers, public, and vendors. The SQPM must protect confidential and proprietary information.

Working Conditions

Work is performed largely remote and/ in an office environment, with minimal chance for personal injury. Respond to various operational, community, customer or employee situations and fulfill multiple priorities within established deadlines. Serve as a representative of the organization at appropriate functions. Work hours are generally during normal business hours. However, unscheduled evening and weekend work will be necessary to meet the needs of the organization. Frequent travel between offices and occasional out-of-town and overnight business travel may be required.

Requirements

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The attributes listed below are representative of the knowledge, skill, and/or ability appropriate for the level of work performed.

• Bachelor’s degree in Healthcare Administration, Business, Nursing, Public Health, Social Work, other related field, or equivalent combination of education and experience (includes knowledge, skills, and abilities).
• Seven (7) years of leadership experience in healthcare services, long-term care, or health insurance industry.
• Ability to effectively collaborate with other disciplines associated with the Family Care program or other long-term care programs.
• Knowledge of federal rules and regulations of Medicaid benefits for long-term care services.
• Demonstrated knowledge of Family Care programs and long-term managed care principles.
• Demonstrated ability to read, analyze, and interpret related documents.
• Ability to respond effectively to sensitive inquiries and situations.
• Demonstrated ability to communicate with diverse sections of the general population and professional community.
• Ability to identify and define issues and opportunities, analyze, and interpret various sources of complex data, and draw valid conclusions to take appropriate action.
• Current driver’s license, acceptable driving record and proof of adequate insurance required.

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Full-time

Job function

• Job function

  Quality Assurance

• Industries

  Hospitals and Health Care

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