Claims Quality Improvement Manager

Job Summary

Leading high-impact quality initiatives in a remote full-time capacity, the Senior Manager, Claims Quality Improvement will drive performance improvements, oversee accreditation processes, and manage large teams to enhance operational excellence and continuous quality improvement across claims operations.

Key responsibilities

• Provide leadership for continuous quality improvement initiatives to enhance efficiency and service quality
• Analyze data and trends to recommend quality improvement opportunities and oversee company-wide quality assessment activities
• Manage large-scale quality initiatives while leveraging technology and automation to strengthen operational controls

Required qualifications

• Bachelor's degree in Business, Healthcare, or a related field; Master's degree preferred
• 5+ years of quality management experience or equivalent leadership experience
• Proven experience managing cross-functional teams on large-scale projects
• Deep expertise in claims operations, quality management systems, and regulatory requirements
• Strong analytical skills with knowledge of Lean/Six Sigma principles