About The Position

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Senior Director of Clinical Quality & Training provides enterprise leadership for internal clinical quality oversight, performance monitoring, and workforce training across a national Medicare Advantage health plan. This role is responsible for building and leading an internal quality audit function focused on employee performance, adherence to clinical standards, and execution of operational workflows. The Senior Director designs and implements comprehensive training and corrective action programs that drive consistent, compliant, and high-quality clinical performance at scale.

Requirements

  • 10+ years of experience in clinical quality, healthcare operations, or performance management within Medicare Advantage or managed care
  • Demonstrated experience auditing internal clinical or operational performance and leading corrective action efforts
  • Proven success designing and implementing large-scale training programs tied to performance outcomes
  • Strong understanding of Medicare Advantage regulations and internal quality oversight expectations
  • Bachelor’s degree required; advanced degree in Nursing, Public Health, Healthcare Administration, or related field preferred
  • Experience building internal quality monitoring or workforce performance programs
  • Background in care management, utilization management, or clinical operations
  • Familiarity with adult learning theory, coaching models, and performance remediation
  • Experience working in highly regulated healthcare environments
  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
  • The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Nice To Haves

  • Active clinical license (e.g., RN, NP, PA, MD/DO) preferred

Responsibilities

  • Internal Clinical Quality Audit & Performance Monitoring Build and lead an internal clinical quality audit function focused on evaluating employee performance, clinical decision-making, documentation, and adherence to policies and workflows
  • Establish audit methodologies, sampling approaches, scoring criteria, and reporting standards to assess quality and consistency of internal clinical work
  • Conduct routine and targeted audits across clinical and operational roles (e.g., care management, utilization management, clinical reviews)
  • Identify performance gaps, patterns of non-adherence, and operational risks; perform root cause analyses to distinguish training, process, and system issues
  • Develop, implement, and oversee corrective action plans (CAPs) tied to audit findings, including retraining, workflow changes, and performance monitoring
  • Track corrective action effectiveness and ensure sustained improvement through follow-up audits and trend analysis
  • Training Strategy, Development & Delivery Own the enterprise clinical quality training strategy aligned to audit findings, regulatory requirements, and operational priorities
  • Design and implement role-based, competency-driven training programs that translate clinical standards and policies into practical, repeatable execution
  • Lead development of standardized curricula, onboarding programs, refresher training, job aids, and performance support tools
  • Ensure training programs are embedded into day-to-day operations and reinforced through leadership coaching and performance management
  • Partner with Learning & Development to leverage adult learning principles, delivery modalities, and learning management systems
  • Corrective Action & Continuous Improvement Integrate audit results and training outcomes into a continuous feedback loop to drive performance improvement
  • Partner with clinical leaders and people managers to support remediation, coaching, and accountability for performance issues
  • Establish governance and escalation processes for significant or repeat performance deficiencies
  • Cross-Functional Leadership & Influence Collaborate with Clinical Operations, Compliance, Human Resources, and Analytics teams to align performance monitoring, training, and corrective action efforts
  • Serve as an internal subject matter expert on clinical quality standards, audit expectations, and workforce readiness
  • Present audit findings, performance trends, and improvement plans to senior leadership
  • Measurement, Governance & Program Leadership Define success metrics for audit performance, training effectiveness, and corrective action outcomes
  • Develop dashboards and reporting to monitor trends, risks, and improvement over time
  • Lead, mentor, and develop a team of quality auditors, trainers, and clinical subject matter experts
  • Manage program budgets and ensure consistent standards across a national footprint
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