Quality Manager

S2Tech•Jefferson City, MO

18h•Onsite

About The Position

We are seeking an experienced Quality Manager to lead all quality management functions for a large-scale Medicaid Prior Authorization (PA) solution implementation and operations program supporting the Missouri MO HealthNet Division. This is a key leadership role responsible for establishing and maintaining a comprehensive quality framework across system implementation, testing, and ongoing operations. The Quality Manager will be on-site in Jefferson City, MO, working closely with State stakeholders, PMO leadership, and cross-functional teams to ensure all deliverables, system functionality, and operational processes meet defined quality standards, regulatory requirements, and CMS certification expectations.

Requirements

Minimum 5+ years of experience leading quality management efforts for: Large-scale IT system implementations or Healthcare/Medicaid operations or Claims processing or call center environments of comparable scale
Demonstrated experience developing and maintaining quality control and QA programs
Proven experience leading system testing efforts across the full SDLC
Strong knowledge of: Quality management methodologies (QA/QC frameworks) Testing strategies and tools Data validation and integrity controls Experience working with health information systems standards
Strong leadership, communication, and stakeholder engagement skills

Nice To Haves

Experience supporting Medicaid or MMIS/PA system implementations
Familiarity with CMS certification processes and requirements
Experience in large-scale public sector or healthcare programs
Experience with automated testing tools and frameworks
Knowledge of data governance and analytics in healthcare systems

Responsibilities

Lead all aspects of quality planning, quality assurance (QA), and quality control (QC) across implementation and operations
Develop, implement, and maintain a Quality Management Plan (QMP) aligned with contract requirements and State expectations
Define and enforce quality standards, metrics, and performance indicators across all deliverables and services
Design and implement a comprehensive testing framework, including: Unit testing System integration testing Regression testing Volume/performance testing User Acceptance Testing (UAT)
Develop and maintain a Test Plan and oversee all testing lifecycle activities
Ensure defects are identified, tracked, resolved, and prevented from reaching production
Establish and execute quality control processes to validate: System inputs/outputs Data integrity Workflow accuracy Operational processes
Oversee deliverable reviews, including reports, documentation, and system enhancements
Ensure consistent application of internal controls and quality checks across all system and operational activities
Ensure accuracy and reliability of: System outputs Data processing and balancing Interface integrations
Validate end-to-end system functionality and alignment with business requirements
Lead and manage QA and testing teams, including assignment of resources and oversight of daily activities
Provide guidance, training, and oversight to ensure staff competency in quality processes and tools
Coordinate with project managers, developers, business analysts, and State stakeholders
Ensure all quality processes support CMS certification readiness, including required documentation and system validation artifacts
Align quality practices with: Medicaid program requirements Federal and State regulations Industry standards for health information systems
Establish a continuous quality improvement framework across implementation and operations
Monitor performance metrics and drive process optimization and defect reduction
Recommend and implement improvements to enhance system quality and operational efficiency