Clinical Quality Manager

Job Summary

A company is looking for a Clinical Quality Manager to oversee national clinical performance and quality initiatives.

Key Responsibilities

• Conduct clinical auditing to identify gaps in documentation and workflows
• Provide education and training for providers on clinical documentation and coding standards
• Monitor and implement quality performance programs aligned with payer contracts

Required Qualifications

• In-depth knowledge of HEDIS, CMS Quality Payment Programs, and value-based reimbursement
• Proficiency in navigating EMR systems and data reporting tools
• 5+ years of experience in physician revenue cycle management focused on clinical quality
• 5+ years of leadership experience in clinical quality and change management
• Associate's degree or higher in a relevant field such as Business or Healthcare Administration