Quality Manager (Remote in USA)
About The Position
As a Quality Manager at HMS (a Gainwell Company), you will be part of an innovative product company with a mission to serve the healthcare needs of our communities. This role provides leadership and direction for quality assurance activities, including auditing, reporting, and continuous improvement initiatives. You will collaborate closely with operational teams to identify trends, develop corrective action plans, and implement best practices that enhance performance and accuracy across all workstreams. Your work directly supports the Account Delivery Manager (ADM), Regional Leader, and internal business partners in achieving or exceeding contractual obligations and company goals and objectives. The person will need to work Alaska Standard Time (AKST) hours.
Requirements
- Minimum of five (5) years of experience with implementing and managing quality control programs; and a minimum of five (5) years of experience leading and influencing large scopes of work in a highly matrixed environment.
- Exceptional written and oral communication and people skills.
- Demonstrated strategic initiative specifically with operating policies and procedures and work process improvements in operations.
- Working knowledge of two or more healthcare business domains, such as Authorized Services, Customer Service Centers, Mailroom Operations, Pharmacy Services, or Provider Enrollment.
- Expertise in data analytics and statistical methodologies, with a strong ability to interpret complex data sets and generate actionable insights. Ensures alignment with industry standards and best practices to support data-driven decision-making.
Responsibilities
- Maintain and improve a robust quality audit program.
- Oversee the day-to-day operations of quality assurance, compliance management, and audit.
- Provide transparent client communications around contractor operations and contractual performance.
- Influence and partner to develop teams and individuals who contribute and support executing day-to-day delivery operations.
- Establish and effectively lead routines regularly and utilize tools and reporting to drive team performance; train and provide ongoing coaching to ensure employee engagement while maintaining client satisfaction.
- Effectively cultivate relationships with account leaders and business partners to proactively identify and enact opportunities to improve the delivery of operational products, services, and capabilities.
- Collaborate with employees and operational leaders to achieve Client Service Level Agreements (SLAs) and drive accountability and efficiency by adopting standard operating procedures.
- Identify and manage existing and emerging risks from business activities and implement mitigation strategies to improve performance.
- Expertise in data analytics and statistical methodologies, with a strong ability to interpret complex data sets and generate actionable insights. Ensures alignment with industry standards and best practices to support data-driven decision-making.
Benefits
- Health (medical, dental, vision) benefits start on day 1 of employment.
- Company match 401K and other benefits available within months of starting.
- New employees are eligible to take advantage of flexible vacation policy after ninety (90) calendar days of employment.
- Company provided computer for work use.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
