Quality Manager, Jordan Valley Senior Care (JVSC) PACE

Jordan Valley Health•Springfield, MO

17h

About The Position

The Quality Manager, in collaboration with the Jordan Valley Health (JVH) Quality and Compliance department, is responsible for designing, implementing, and sustaining a comprehensive quality improvement (QI) and compliance plan for Jordan Valley Senior Care. This position serves as the program’s quality lead, ensuring adherence to federal and state PACE regulations. The Quality Manager collaborates with JVH compliance team to coordinate JVSC internal and external auditing activities, manages federal and state reporting obligations, participates in JVH’s Quality and Compliance committee and acts as the primary contact for CMS and the Missouri state Medicaid agency on regulatory and quality matters. The Quality Manager reports directly to the Executive Director and is matrixed with the JVH Compliance Director. This role serves as a liaison between JVSC quality/compliance activities and other JVH programs.

Requirements

Bachelor’s degree in healthcare administration, Public Health, Nursing, Health Information Management, or equivalent work experience.
Minimum of 3-5 years of experience in managed care, Medicare/Medicaid compliance, or quality improvement, with at least 2 years in a supervisory or program management role
Direct experience managing CMS audits, internal audit programs, or regulatory reporting is required
Either one year of experience working with a frail or elderly population or, in the absence of such experience, receive appropriate training from the JVSC on working with a frail or elderly population upon hire.
Basic Life Support (BLS) required, must obtain within first 90 days of employment

Nice To Haves

Experience working with Missouri state agencies (MO HealthNet, DHSS, DSS) preferred
PACE experience preferred
Prior direct experience in a PACE organization as a compliance or quality professional
Familiarity with the National PACE Association (NPA) quality frameworks and industry benchmarks
Experience with CMS audits or OIG investigations
Knowledge of Missouri Adult Protective Services system and mandatory reporting procedures
Experience implementing PDSA cycles, Lean methodology, or similar QI frameworks in healthcare settings

Responsibilities

Lead the design, implementation, and ongoing management of the quality improvement program for Jordan Valley Senior Care.
Ensure compliance with federal and state PACE regulations, CMS requirements, Missouri Medicaid/MO HealthNet guidance, and internal organizational standards.
Coordinate internal and external audit activities, including CMS/state audits, mock audits, audit tracking, corrective action plans, and post-audit analysis in conjunction with JVH Compliance team.
Oversee required federal and state reporting, including HPMS submissions, attestations, reportable events, grievances, appeals, and critical incident notifications.
Develop and manage annual quality work plans, monitoring activities, audit tools, and dashboards to identify trends, risks, and improvement opportunities for Jordan Valley Senior Care.
Lead or co-lead Quality Improvement Committee activities and partner with clinical, operational, compliance, and executive leaders on quality initiatives.
Manage formal quality improvement projects using structured methodologies such as PDSA, Lean, or similar frameworks for Jordan Valley Senior Care.
Monitor quality performance measures related to preventive care, chronic disease management, medication safety, falls, pressure injuries, hospital utilization, participant satisfaction, and care planning.
Oversee grievance, appeals, and mandatory reporting processes to ensure timely and compliant resolution for Jordan Valley Senior Care.
Support fraud, waste, and abuse prevention efforts, including training, auditing, investigations, corrective actions, and regulatory reporting for Jordan Valley Senior Care, in collaboration with JVH Compliance team.
Partner with leadership and department managers to maintain current policies, translate regulatory updates into operational changes, and support staff training for Jordan Valley Senior Care.
Promote a culture of quality, accountability, transparency, regulatory readiness, and ethical conduct across Jordan Valley Senior Care.

Benefits

Medical and Prescription Drug Coverage: Three comprehensive plan options (Buy-up, Base, and High Deductible) through UnitedHealthcare's Choice Plus network, covering various deductibles and out-of-pocket limits. Includes access to telemedicine services via Teladoc.
Health Savings Account (HSA): Available for employees in the High Deductible Plan with employer contributions and tax advantages.
Flexible Spending Account (FSA): Options for both healthcare and dependent care FSAs, allowing pre-tax contributions for qualified expenses.
Dental and Vision Coverage: Dental insurance through Cigna’s DPPO network and vision coverage through EyeMed’s Insight network.
Retirement Plan: Pre-tax and Roth 403(b) retirement plans with a 5% employer match starting after 30 days of employment.
Life and Disability Insurance: Basic Life and AD&D insurance provided at no cost, with the option to purchase additional coverage. Long-term and short-term disability insurance are also available.
Employee Assistance Program (EAP): Free confidential support for personal and professional challenges, including counseling and crisis intervention.
Additional Voluntary Benefits: Options for critical illness, accident, hospital care, and pet insurance through MetLife.
Pay on Demand Available.
Nine paid holidays per year.