Lead the quality assurance efforts ensuring program compliance with healthcare quality standards,
Conduct regular audits,
Implement performance improvement strategies to meet quality metrics.
Develop quality assurance programs ensuring that data, metrics, and reports gathered, managed, and reported are within contract standards and ensures compliance with credentialing and training of all personnel.
Serve as a member of the leadership project management team ensuring service delivery and contract deliverable execution.
Manage and implement approaches to provide quality throughout the program.
Create and update the QMP.
Assess performance and reports progress against metrics and SLAs.
Develop PQI standards and monitors quality standards against accreditation standards across the program.
Review incidents, accidents, grievances, identifies patterns, trends and recommends areas for improvement.
Ensure accreditation standards are met when indicated.
Review case records to evaluate the presence, clarity, quality, and continuity of required documents.
Ensure mandates, laws and policies are followed.
Supervise quality and reporting staff.
Design, implement, monitor quality operations and compliance.
Responsible for performance measurements and analytics, customer reporting, policies and procedures, quality of all services and service delivery tracking, coordination of satisfaction surveys, performance guarantee tracking, integration of quality improvement processes and compliance oversight.

Bachelor’s degree in healthcare management, business administration, communication, IT, social science, or a related field.
Minimum of 3 years experience managing a QA program in healthcare or telehealth setting including a required nurse or medical clinical background.
Minimum 3 years experience including:* Developing and managing quality metrics, auditing processes, and performance improvement methodologies.
Ability to develop and implement QA protocols and conduct regular reviews.
Demonstrated success in applying interpersonal, analytical, organizational, and communications skills in managing a quality assurance program.
Demonstrate knowledge of QA best practices.
Ability to pass a criminal history, fingerprint background checks, and credential review/verification.
This position is a remote position and requires a quiet, private, confidential space to work from as well as having access to your own reliable high-speed internet hard wired to your home or apartment (coax or fiber from the Internet Service Provider (ISP) to your home. Using a hot spot from a mobile device (tethering) or wireless ISP is not acceptable.
4 years management experience in a large call center setting
Direct military affiliation or military spouse
Certified Professional in Healthcare Quality (CPHQ)
Certified Manager of Quality/Organizational
Certified Quality Auditor (CQA)
ISO 9001 Lead Auditor
Certified in Healthcare Compliance (CHC)

Quality Control Manager

Key skills