Lead quality program management activities to ensure compliance with state, federal, and NCQA requirements.
Oversee complex quality deliverables including audits, accreditation surveys, and performance reports.
Collaborate with quality leadership and cross-functional teams to monitor performance and drive continuous improvement.
This organization partners with health plans to implement quality improvement programs and ensure compliance with regulatory standards such as NCQA and HEDIS. The culture emphasizes collaboration, regulatory excellence, and continuous improvement, with a remote work environment for professionals based in Michigan.
Collaborate with health plan leaders to develop quality data strategies and reporting on HEDIS and CAHPS performance.
Oversee data ingestion, validation, and documentation to improve accuracy across EHR, HIE, and supplemental data.
Support regulatory compliance and HEDIS audit readiness while monitoring quality programs and reporting risks.
This organization is a healthcare quality partner focused on national performance initiatives, including HEDIS, CAHPS, and data analytics. It provides a highly collaborative, matrixed environment with opportunities for cross-functional exposure and remote work.
Build and sustain relationships with health plan executives to drive mutual success in value-based care.
Lead partnership governance structures, presenting Aledade's value proposition and aligning on shared strategic goals.
Direct a high-performing team, translating organizational goals into actionable targets and optimizing resource allocation.
Aledade PBC is a public benefit corporation that empowers independent primary care practices to thrive in value-based care. Founded in 2014, it has become the largest network of independent primary care in the country, fostering a collaborative, inclusive, and remote-first culture.
Lead clinical care model execution and scalable systems integration across all markets.
Drive value-based performance metrics including patient engagement, HEDIS/STARs, and total cost of care.
Manage and mentor clinical directors and care teams while partnering with product and operations.
Accompany Health provides primary, behavioral, and social care for patients with complex needs, offering at-home and virtual care with 24/7 support. Their distributed, mission-driven teams collaborate to deliver high-quality, evidence-based care.
Lead and oversee multiple healthcare audit projects, including PMV and HEDIS activities, from planning through reporting.
Supervise and mentor audit staff, manage budgets and schedules, and serve as a liaison with state Medicaid agencies.
Drive quality improvement, prepare proposals, and present results to clients and stakeholders.
HSAG is a nationally recognized healthcare quality improvement organization specializing in audits, data analysis, measure development, and survey research. The company fosters a supportive culture with work-life balance, flexible schedules, and a commitment to growing staff into future healthcare leaders.
Lead enterprise-wide quality strategy and compliance excellence, driving design, implementation, and continuous improvement of the PACE quality program.
Partner cross-functionally with Analytics, Compliance, and Operations to turn complex data into actionable insights and elevate quality.
Oversee Quality Operations teams, regulatory reporting, and corrective action plans to ensure participant safety and readiness.
WelbeHealth serves communities' most vulnerable seniors through PACE programs, focusing on participant-centered care. The company values pioneering spirit and offers a collaborative culture with comprehensive benefits and a commitment to diversity and inclusion.
Lead the strategy and execution of provider-facing risk adjustment initiatives.
Partner with teams like Network, Data Science, and external providers for cross-functional program delivery.
Analyze provider performance to identify opportunities and develop improvement plans.
Oscar is a health insurance company built around a full-stack technology platform focused on serving its members. Founded in 2012, Oscar is a sizable organization that fosters a culture of authenticity and belonging.
Manage a patient and provider panel to identify and close HEDIS and Medicare Stars quality gaps through targeted outreach and education.
Partner with nephrology and primary care practices to interpret quality data and implement actionable improvement workflows.
Collaborate cross-functionally with clinical, coding, and pharmacy teams to drive performance, compliance, and patient well-being.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic approach. The company is committed to improving outcomes for patients with kidney disease by providing interdisciplinary resources, analytics, and services.
Drive the department's strategy, program design, and implementation to enhance program value.
Understand competitive landscape, member needs, and healthcare trends; serve as a thought leader.
Lead cross-functional initiatives, manage budgeting, and develop direct reports.
Oscar is a health insurance company built around a full stack technology platform and a relentless focus on serving members. Founded in 2012, it aims to behave like a doctor in the family and supports authentic, diverse perspectives.
Shape enterprise strategy for provider data quality, governance, and directory accuracy across a nationwide healthcare network.
Lead governance frameworks, auditing programs, and compliance with CMS requirements.
Drive innovation through automation, analytics, and executive stakeholder collaboration.
This role is with a partner company in the healthcare sector, operating a nationwide provider network focused on data quality and governance. The company emphasizes innovation, enterprise-wide transformation, and data-driven decision-making.
Lead and manage the coding team, setting productivity and quality standards for documentation and coding operations.
Oversee pre-encounter review workflows, query auditing, and vendor performance to drive compliance and risk adjustment outcomes.
Collaborate with clinical, operations, compliance, and finance stakeholders on program objectives and process improvements.
WellBe Senior Medical provides healthcare services focused on seniors, with an emphasis on documentation accuracy, coding compliance, and risk adjustment. The company operates in a remote, cross-functional environment and values compliance, quality, and continuous improvement.
Lead strategic and operational oversight for Medicaid external quality review contracts, ensuring compliance, quality, and timely deliverables.
Serve as the senior relationship manager for state Medicaid agencies and stakeholders, proactively resolving concerns and driving customer satisfaction.
Direct project planning, budgets, staffing, and team development while identifying risks and supporting business development initiatives.
Health Services Advisory Group (HSAG) is a national healthcare quality consulting organization that partners with states to improve healthcare delivery through external quality reviews and data-driven solutions. The company fosters a mission-driven, collaborative culture dedicated to making healthcare better for communities and clients.
Interpret federal and state regulations to ensure compliance and drive process improvements.
Analyze data in Excel to identify trends, savings, and process improvements.
SIHO Insurance Services provides health insurance administration and related services, focusing on payment integrity and regulatory compliance. The company operates in a managed care environment and emphasizes collaboration, professionalism, and adaptability among its employees.
Lead sales strategy for risk adjustment and quality solutions in health plans.
Build executive relationships and align SaaS/BPaaS offerings to business goals.
Manage enterprise sales from discovery to contracting, with ~33% travel.
The company provides SaaS and BPaaS solutions for healthcare risk adjustment and quality improvement. It serves health plans across Medicare Advantage, ACA, and Managed Medicaid markets with a remote-first, collaborative culture.
Leads and develops a team of Medical Directors and Clinical Directors driving clinical strategy across enterprise value-based care contracts.
Owns clinical performance outcomes, resource deployment, and strategic market relationships.
Recruits and mentors clinical leaders while representing the clinical voice in company-wide strategy.
Aledade PBC is a public benefit corporation that empowers independent primary care practices by building value-based care contracts and technology. Founded in 2014, it is the largest network of independent primary care in the U.S. and fosters a collaborative, inclusive, remote-first culture.