H20 Quality Management Administrator

Solari•Tempe, AZ

3d•$63,175 - $76,000•Hybrid

About The Position

The H2O Quality Management Administrator leads quality management and compliance oversight for Solari’s administration of the AHCCCS Housing and Health Opportunities (H2O) program. The role oversees provider quality, performance monitoring, data integrity, utilization, service and billing audits, corrective actions, and performance reporting to support regulatory compliance, program integrity, and positive member outcomes. The administrator serves as the primary operational liaison on H2O quality matters with AHCCCS, Banner Compliance, housing service providers, and internal stakeholders. The position supervises QM staff, establishes quality monitoring processes and accountability measures, and works across Provider Support, Operations, Claims, Compliance, and Evaluation & Impact to identify risk, improve performance, and strengthen service delivery. This position reports to the Director, Housing Eligibility and directly supervises one employee. It is classified as exempt. Solari describes the work arrangement as including a hybrid schedule. The salary range is $63,175–$76,000 USD.

Requirements

3–5 years of experience in the field; required.
Bachelor’s degree in Healthcare Administration, Public Administration, Social Work, Business Administration, Public Health, Data Analytics, Human Services, or a related field; required.
Advanced knowledge of quality management, quality assurance, compliance monitoring, corrective action, and continuous improvement practices.
Knowledge of AHCCCS requirements, Medicaid or other publicly funded service programs, and applicable regulatory and contractual requirements.
Understanding of housing and homeless service delivery, including Housing First principles, Permanent Supportive Housing practices, services for individuals with a Serious Mental Illness (SMI) designation, provider performance management, utilization monitoring, claims and billing processes, and performance measurement.
Strong analytical skills, including the ability to interpret data, identify trends and risks, and translate findings into actionable recommendations.
Ability to interpret policies, contractual requirements, and regulatory guidance and translate them into operational processes and quality standards.
Strong written and verbal communication skills and the ability to communicate quality expectations, findings, and recommendations to internal and external stakeholders.
Ability to lead cross-functional initiatives, manage competing priorities, and maintain effective relationships with providers, regulators, and organizational leaders.
Ability to act professionally and maintain appropriate boundaries with clients and staff.
Ability to report to work, meetings, training, and job-related activities as scheduled and prepared.
Ability to demonstrate compassion, effort, and ownership in interactions and work.
Openness to learning, participating in discussions, trying new approaches, and engaging in self-awareness and reflection for continual personal, professional, and leadership growth.
While working from a home office, maintain a stable and secure private home internet connection with minimum speeds of 50 Mbps download and 5 Mbps upload and average jitter below 20% of latency.

Responsibilities

Lead and administer the H2O Quality Management Program in accordance with AHCCCS policies, H2O program requirements, contractual obligations, and organizational standards.
Serve as the primary point of contact for AHCCCS, the H2O provider network, and Banner Compliance regarding quality management, compliance concerns, audits, monitoring activities, and corrective action plans.
Establish and oversee monitoring and quality assurance processes for provider performance, service delivery, documentation, utilization, and program compliance.
Analyze quality and compliance findings to identify trends, performance gaps, risks, and opportunities for improvement.
Coordinate corrective action and quality improvement initiatives with providers, internal teams, and external compliance partners.
Lead organizational readiness and follow-up for AHCCCS reviews, audits, and quality monitoring activities.
Oversee H2O data quality processes to support accurate, complete, and timely documentation and reporting.
Monitor and analyze provider performance metrics, service utilization, housing outcomes, and quality indicators.
Develop, validate, analyze, and present reports related to H2O enrollment, housing stability, service delivery, utilization, and provider performance.
Partner with Quality Management Specialists, Business Analysts, the Evaluation & Impact Manager, and operational teams to identify trends, service gaps, operational risks, and improvement opportunities.
Ensure quality monitoring and reporting align with AHCCCS performance expectations and contractual requirements.
Oversee provider quality monitoring and identify trends requiring education, technical assistance, or performance improvement.
Collaborate with Provider Support to identify training needs and coordinate education on H2O requirements, documentation standards, billing expectations, housing care planning, and quality measures.
Oversee provider corrective action plans and performance improvement activities, monitor progress, and evaluate whether identified concerns are resolved.
Serve as an escalation resource for provider quality, compliance, and service delivery concerns.
Coordinate quality oversight of H2O claims, billing, reimbursement, and service authorization issues that may affect provider performance, compliance, or member service delivery.
Partner with providers, Banner, Claims, and internal teams to investigate and resolve systemic billing or claims-related concerns.
Analyze claims and billing trends to identify recurring issues, compliance risks, and process improvement opportunities.
Develop guidance, workflows, and quality controls to reduce recurring issues and unnecessary escalations.
Supervise, coach, and provide direction to Quality Management Specialists and other assigned H2O staff.
Establish and maintain quality monitoring procedures, workflows, tools, documentation standards, and accountability measures.
Facilitate collaboration among Quality Management, Provider Support, Operations, Claims, Compliance, Business Analytics, and Evaluation & Impact.
Lead quality-related meetings, provider reviews, performance discussions, and stakeholder engagement activities.
Drive continuous quality improvement initiatives focused on housing stability, member outcomes, provider performance, compliance, and program effectiveness.
Perform other duties as assigned.

Benefits

Generous paid time off (PTO).
Medical, dental, and vision health benefits starting the first of the month following hire.
Competitive compensation.
Hybrid schedule and convenient office locations.
Free access to an on-site fitness room at the Tempe office.
Basic life insurance.
Voluntary life insurance and spouse and child insurance.
Critical illness coverage with free dependents and separate spouse coverage.
Short-term and long-term disability, starting the first of the month after 90 days of employment.
401(k) and Roth 401(k), starting the first of the month after 90 days of employment.
United Pet Care.
LifeLock identity theft protection.
LYRA EAP Program with 25 free mental health sessions per family member.