The Manager of Quality Improvement provides leadership and operational
management of Alliance Health’s Quality Improvement (QI) Program, ensuring
alignment with organizational goals, regulatory requirements, and accreditation
standards. This position is responsible for translating organizational,
regulatory, contractual, and quality priorities into structured improvement
initiatives that produce measurable improvements in member outcomes, service
quality, organizational performance and health equity.
The manager leads the development of quality improvement initiatives through the
application of recognized quality improvement methodologies, data driven
approaches, and performance improvement frameworks to drive measurable
improvements in quality, access, member experience, and health outcomes. The
Manager oversees Performance Improvement Projects (PIPs), quality analytics,
data validation, performance measurement, reporting, and regulatory submissions,
while ensuring compliance with federal and state Medicaid managed care
requirements, accreditation standards, and contractual obligations.
This position is full-time remote. Selected candidate must reside in North
Carolina. Some travel for onsite meetings to the Home office (Morrisville, NC)
may be required.
Responsibilities & Duties
Quality Improvement
The role serves as a leader in quality improvement, healthcare analytics,
regulatory compliance, performance management, utilizing data-driven insights
to identify opportunities, monitor outcomes, and support organizational
decision-making
Execute, deliver, and lead quality strategy, annual work plans, quality
committees, governance activities, continuous quality improvement culture,
and enterprise quality initiatives
Oversee development, review, implementation, evaluation, and reporting of
PIPs, corrective action plans, quality initiatives, state reports, and
regulatory deliverables
Evaluate intervention effectiveness and sustainability
Analyze quality, utilization, access, operational, and member experience
measures. Calculate absolute and relative change, benchmark comparisons,
trend analyses, and identify meaningful performance variation
Advanced knowledge of Medicaid managed care quality programs, State
deliverables, PIPs, QAPI, HEDIS, quality improvement analytics and
statistical interpretation methodologies including absolute and relative
change calculations, PDSA, Root Cause Analysis, PDSA, Driver Diagrams,
process mapping, SMART AIM development etc.
Incorporate assessment and evaluation of disparities, access barriers, social
drivers of health, equity opportunities, and support the development of
targeted interventions to improve outcomes
Stakeholder consultation and collaboration, change management concepts.
Collaborate with Medical Management, Care Management, Provider Network,
Population Health, Analytics, Compliance, Operations, and Executive
Leadership to advance quality initiatives across the organization
Maintain compliance, confidentiality, ethical standards, professional
credibility, and current knowledge of healthcare quality trends
Performance Measurement and Data Analysis
Partner with Clinical Quality Analytics, HEDIS Performance Team, Population
Health, Information Technology, and other teams to identify and monitor
meaningful quality indicators
Interpret performance trends and translate data into actionable improvement
strategies. Identify signals of improvement, remaining gaps, unintended
consequences, sustainability risks, and next best tests of change
Validate that improvement measures appropriately assess whether interventions
are producing intended outcomes
Responsible for the development of reports, dashboards, and executive
presentations to support Quality Improvement initiatives with internal and
external stakeholders, including the NC DHHS
Present complex performance information in a clear, actionable format for
operational and executive audiences
People Leader
Work with Human Resources to attract, maintain, and retain a highly qualified
and well-trained workforce
Directly supervise staff, conduct evaluations, provide coaching, manage
productivity, support hiring, onboarding, retention, and workforce
development
Actively establish and promote a positive, diverse, and inclusive working
environment that builds trust
Ensure all staff are treated with respect and dignity
Ensure standards are transparent and applied consistently, impartially, and
ethically over time and across all staff members
Work to resolve conflicts and disputes, ensuring that all participants are
given a voice
Support a learning environment and culture of quality to advance team skills
and professional development
Cultivate and encourage efforts to expand cross-team collaboration and
partnership
Build relationships and identify gaps with partnerships across the
organization and with external/community stakeholders to support program
operations
Manager Operational Functions
Manage and ensure compliance with organizational policies and labor law
requirements for timesheets, time off utilization, and overtime utilization
Monitor team member productivity, progress towards goals, and measure against
KPIs
Collaborate with supervisor, and HR as needed, regarding formal coaching
notes, written warnings, and performance improvement plans
Direct coaching through 1:1 check-ins with assigned staff
Facilitate at least monthly team meetings to review operations updates and
expectations
Ensure that the team has the needed tools and resources to achieve outreach
goals and ensure compliance with regulatory and accreditation requirements,
with recommendations and advocacy for the appropriate resources
Accountable to ensure organized workflows that contribute to staff
understanding of their roles and responsibilities
Professional Integrity
Foster a collaborative, inclusive, and positive work environment
Maintain composure and efficiency in high-pressure situations, ensuring all
tasks are completed within established timelines
Handle sensitive situations with tact and professionalism, fostering positive
relationships both internally and externally
Adhere and monitor staff compliance with all Alliance Organizational Policies
and Procedures
Conduct self for alignment with system strategy, vision, mission, and values
and ensure support of department specific goals and objectives
Maintains knowledge of current trends, evidence-based practices in the field
Minimum Requirements
Education & Experience
Required:
Bachelor’s degree in healthcare administration, Public Health, Nursing, Health
Informatics, Business Administration or related healthcare field and five (5)
years of healthcare quality improvement, analytics, population health, or
performance improvement experience including two (2) years of leadership
experience and health plan quality experience.
Preferred:
Master’s degree (MPH, MHA, MBA, Nursing, Epidemiology, Biostatistics,
Informatics, Population Health) and five (5) years of healthcare quality
improvement, managed care, analytics, population health, or performance
improvement experience and three (3) years of leadership experience and health
plan quality experience.
Certified Professional in Healthcare Quality (CPHQ), Lean Six Sigma Black Belt
(LSSBB) preferred.
Knowledge, Skills, & Abilities
Computer proficiency in Microsoft Excel, Teams, Word and Outlook.
Ability to utilize computer equipment and web-based software to conduct work.
Ability to interact with various office staff as needed to support necessary
workflows.
Ability to communicate effectively to individuals and groups through spoken,
written and electronic media.
Ability to attend to detail, effectively prioritize and execute tasks in a
timely manner.
Ability to work independently without a high degree of supervision.
Knowledge of Medicaid Managed Care Organizations
Knowledge of NCQA, HEDIS, DHHS, and Value-Based Care
Knowledge of physical and behavioral health, SDOH, Access, and other
influences of health
Salary Range
$79,425 -$101,267/Annually
Exact compensation will be determined based on the candidate's education,
experience, external market data and consideration of internal equity
An excellent fringe benefit package accompanies the salary, which includes:
Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility