About The Position

At Zelis, we Get Stuff Done. So, let’s get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients. At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview The Sr. Manager, Quality, Performance & Enablement is responsible for owning and leading the Quality Enablement function across Pricing Solutions, including audit, performance enablement, training, and SOP governance. This role defines and drives the end-to-end quality and performance improvement strategy across multiple products, ensuring consistent execution, regulatory alignment, and measurable business outcomes. This leader oversees audit strategy and execution across network, claims, and product workflows, and is accountable for translating audit insights into scalable performance improvements. The role also owns the development and implementation of enterprise audit tooling, enabling automation, visibility, and consistency across the organization. Operating across Product Delivery, Operations, UAT, Compliance, and Process Excellence, the Sr. Manager ensures that quality standards, policies, and enablement practices are consistently applied and drive sustained improvements in performance, accuracy, and client outcomes.

Requirements

  • 10–12+ years of experience in operations, quality, audit, or performance improvement leadership
  • Proven experience leading multi-team functions or complex cross-functional capabilities
  • Experience designing and implementing audit frameworks, performance programs, or enablement strategies
  • Experience building or implementing tools, systems, or automation solutions preferred
  • Strong analytical mindset with ability to translate data into business outcomes
  • Demonstrated ability to influence and lead across multiple teams and stakeholders
  • Strong leadership, communication, and organizational skills
  • Key Competencies Strategic thinking with strong operational execution
  • Data-driven decision making
  • Influence and cross-functional leadership
  • Change management and organizational alignment
  • Continuous improvement mindset

Responsibilities

  • Own the Quality, Performance & Enablement function across Pricing Solutions, including audit, training, SOP governance, and performance improvement
  • Lead and develop a team of Performance Enablement Analysts, audit specialists, and technical writers
  • Establish organizational standards for quality, training, and execution across multiple products and workflows
  • Drive alignment and consistency across teams, ensuring scalable and repeatable practices
  • Define and lead audit strategy across Pricing Solutions, including network audits, claims audits, and system/process audits
  • Oversee execution of audits across multiple products, ensuring consistency, accuracy, and regulatory alignment
  • Own the design, build, and implementation of enterprise audit tooling to support scalable audit execution and reporting
  • Establish audit methodologies, scoring models, and quality standards across the organization
  • Ensure centralized visibility into audit performance through dashboards and reporting
  • Own the closed-loop performance improvement model (Audit → Insight → Enablement → Measurement) across Pricing Solutions
  • Translate audit insights into structured uptraining programs, SOP improvements, and performance interventions
  • Ensure measurable improvement in quality, productivity, and accuracy across teams
  • Drive adoption of enablement programs across multiple teams and workflows
  • Define and govern SOP frameworks across Pricing Solutions, ensuring consistency, clarity, and alignment with business operations
  • Establish and manage the process for policy and procedure development, maintenance, and updates
  • Partner with Compliance Operations to ensure alignment with regulatory requirements and policy enforcement
  • Drive standardization of workflows and documentation across the organization
  • Partner with Product Delivery, Operations, UAT, Process Excellence, and Compliance to align quality and performance standards
  • Influence cross-functional stakeholders to drive consistent execution and adoption of best practices
  • Serve as the central point of coordination for quality and performance initiatives across products
  • Support release readiness by ensuring training, SOPs, and quality standards are in place
  • Define and manage KPIs tied to quality, performance, and operational outcomes (error rates, SLA adherence, audit scores, etc.)
  • Track and report on improvements in performance, efficiency, and business outcomes
  • Partner with Finance and leadership to quantify impact, including cost savings, error reduction, and ROI
  • Drive accountability for sustained performance improvements across stakeholders
  • Identify opportunities to improve efficiency, scalability, and quality through process optimization and automation
  • Partner with Process Excellence and Technology teams to enhance workflows and systems
  • Drive modernization of audit, training, and performance enablement practices across the organization
  • Ensure the function scales effectively as the business grows across products and markets
  • Performs other duties as required.
  • Must be available to travel 10% - 20% as required to meet business needs.

Benefits

  • 401k plan with employer match
  • flexible paid time off
  • holidays
  • parental leaves
  • life and disability insurance
  • health benefits including medical, dental, vision, and prescription drug coverage
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