Responsibilities

• Administer quality programs across service lines or populations, collaborating with clinical operations managers to address risks and lead improvements.
• Partner with Health Economics, Research, and Clinical Affairs teams to refine clinical effectiveness measures.
• Analyze clinical quality data, including documentation reviews, patient outcomes, satisfaction, and call evaluations.
• Perform and audit case and call reviews to ensure consistent, high-quality feedback.
• Identify improvement opportunities and work with management, training, and operations teams to implement solutions.
• Investigate and address complaints, quality issues, and patient safety events, participating in RCA2 processes.
• Support training plans by defining relevant goals for specific services or populations.
• Represent clinical quality in client meetings, audits, and internal presentations, contributing to top priority areas.
• Collaborate with the credentialing team to support committee activities and recommend performance improvement plans.
• Uphold security and HIPAA regulations, modeling our culture and values in all work.

Qualifications

• Physician or NP with a current unrestricted US license and 3+ years of experience
• Board certification required for physicians
• At least 1 years experience in a healthcare quality role or 3 years experience in progressively responsible leadership roles
• Licensed and in good standing with state medical board(s)
• Be able to write and communicate medical information at a level appropriate to different audiences, including other clinicians, patients, analysts/data scientists, and executives.
• Prior experience in healthcare quality or CPHQ is valued
• Prior experience with analysis and reporting software (Looker, Tableau) or advanced features of spreadsheets (can perform complex functions)
• Be systems-oriented, analytical, and understand how the different parts of the healthcare system work together (or don’t) to produce an observed result.
• Agile and comfortable with working in an environment that values change.
• Continuous improvement mindset and willingness to teach and to learn from other members of the team
• This is a remote position, so a reliable high-speed internet connection is required.
• Enjoy remote flexibility with occasional travel (~5-10%)

Physical/Cognitive Requirements

• Prompt and regular attendance at assigned work location.
• Capability to remain seated in a stationary position for prolonged periods.
• Eye-hand coordination and manual dexterity to operate keyboard, computer and other office-related equipment.
• No heavy lifting is expected, though occasional exertion of about 20 lbs of force (e.g., lifting a computer \/ laptop) may be required.
• Capability to work with leadership, employees, and members in an appropriate manner.