Quality Manager for Outpatient Services

Clinical Quality & Patient Safety

Develop, implement, and monitor the organization’s Quality Improvements in all programs.

Conduct audits, chart reviews, and performance improvement initiatives in collaboration with clinical teams.

Monitor patient satisfaction and clinical outcomes, ensuring alignment with internal goals and external benchmarks.

Facilitate organization-wide education and training on quality, compliance, and patient safety standards. Payer Incentives & Health Insurance Reporting

Oversee all quality-related reporting and deliverables tied to commercial and governmental payer contracts (e.g., HEDIS, Stars, QIP, ACO/MSSP).

Collaborate with Population Health and Revenue Cycle teams to ensure timely and accurate submission of required quality data.

Identify and drive performance on metrics linked to pay-for-performance and value-based reimbursement programs.

Analyze gaps in care and performance trends to inform targeted interventions that maximize financial incentives and improve patient outcomes.

Serve as a liaison with payers on quality program requirements, audits, and performance improvement plans. Compliance & Accreditation

Ensure compliance with regulatory agencies such as CMS, Joint Commission, NCQA, and state health departments.

Support survey readiness, accreditation activities, and policy development.

Manage corrective action plans and continuous readiness programs. Education

Bachelor’s degree in Population Public Health, Health Administration, or related field required. Experience

3–5 years of experience in healthcare quality, patient safety, or population health.

Experience with quality-based payment models (e.g., Medicare Advantage, ACO, PCMH, commercial incentives).

Familiarity with clinical quality measures (e.g., HEDIS, Stars, MIPS, CAHPS) and data submission platforms. Skills

Strong analytical and data interpretation skills.

Excellent verbal and written communication.

Knowledge of EMRs, payer portals, and quality reporting tools.

Strong leadership and project management capabilities.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

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