Senior Manager, Clinical Quality

Abby Care•San Francisco, CA

5d•$120,000 - $150,000•Hybrid

About The Position

Abby Care is seeking a visionary and execution-focused Senior Manager, Clinical Quality to architect, scale, and oversee their clinical quality assurance and compliance frameworks. This role reports directly to corporate clinical leadership and is responsible for safeguarding clinical excellence across their expanding footprint. The ideal candidate is a high-EQ clinical leader who thrives in a fast-paced, startup environment, translating complex multi-state Medicaid regulations into seamless, tech-enabled clinical workflows to ensure high-quality, compliant care that keeps families safely at home.

Requirements

Bachelor of Science in Nursing (BSN) required.
Current, active, and unencumbered license as a Registered Nurse (RN).
Minimum of 5 years of licensed clinical nursing experience.
At least 2–3 years in home health care, community health, or managed care environments.
Minimum of 2 years of dedicated, proven experience in clinical quality management, healthcare compliance, or utilization review.
Ability to work flexible hours to match the urgent needs of an evolving startup market.
Willingness to travel locally/regionally as required for state audits and clinical evaluations.

Nice To Haves

Master’s degree in Nursing (MSN), Healthcare Administration (MHA), or Public Health (MPH) preferred.
Multi-state/Compact licensure is highly preferred, or a willingness to rapidly obtain licensure in upcoming expansion states.
Deep knowledge of OASIS, Home Health Agency (HHA) regulations, and CMS/Medicaid audit processes is highly preferred.

Responsibilities

Design, implement, and evaluate Abby Care’s multi-state Clinical Quality Improvement (CQI) and Quality Assurance (QA) programs.
Partner closely with state Directors of Nursing and Clinical Leads to standardize clinical practices across all active and upcoming markets.
Build a deeply rooted organizational culture that prioritizes patient safety, exceptional care, and caregiver compliance.
Serve as the internal subject matter expert on state-specific Medicaid paid family caregiving regulations, Electronic Visit Verification (EVV), and Home Health Agency (HHA) scope of practice.
Maintain and guarantee perpetual audit-readiness for state Departments of Health (DOH), CMS, and commercial payer reviews.
Deliver targeted remediation training and policy updates to clinical leadership when compliance gaps or regional regulatory updates occur.
Oversee corporate charting standards and multi-state clinical audit frameworks.
Establish performance benchmarks for electronic charting, ensuring clinical necessity is robustly documented to protect authorization utilization and minimize compliance risk.
Analyze complex clinical data and Key Performance Indicators (KPIs), including patient readmission rates, extended visit trends, and clinical incident reports, to drive meaningful interventions and workflow improvements.
Oversee the formal escalation, investigation, and reporting of all critical incidents across operations.
Ensure thorough Root Cause Analyses (RCA) are completed for variances and promptly deploy sustainable Corrective Action Plans (CAPs).