Manager – Healthcare Quality Project Management

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Plan, oversee, and manage several large and intricate projects.

• Direct NCQA Accreditation project management tasks, including the development of work plans, milestone tracking, risk management, document collection, and coordination with stakeholders.

• Coordinate accreditation preparedness across Quality Management, Medical Management, Provider Services, Member Services, Operations, Compliance, and other functional departments.

• Establish governance frameworks, project timelines, status reports, and communications for executive levels.

• Monitor accreditation standards and requirements while supporting ongoing compliance efforts.

• Facilitate accreditation workgroups, steering committees, and readiness assessments.

• Manage document repositories, evidence collection processes, policies, procedures, and other materials necessary for accreditation.

• Track and report on accreditation readiness metrics, action plans, and remediation efforts to leadership.

• Assist with state regulatory audits, quality program evaluations, and external review processes.

• Align accreditation requirements with the organization's quality strategy.

• Lead action planning following surveys and continuous improvement initiatives that arise from accreditation and regulatory findings.

⛳️ Requirements

• A minimum of 3 years' experience in Project Management.

• Capability to manage multiple projects at the same time.

• Strong leadership abilities and the capacity to facilitate cross-functional teams.

• Exceptional written and verbal communication skills.

• Over 5 years' experience in managed care.

• Proficient in Excel and other Microsoft software/tools.

• Experience in leading complex cross-functional projects using established project management methodologies.

• Background in managing regulatory, compliance, accreditation, or healthcare quality initiatives.

• Understanding of NCQA standards, accreditation procedures, and principles of healthcare quality improvement.

• Ability to coordinate various stakeholders and ensure accountability for deliverables.

• Preferred experience in Medicaid managed care and healthcare quality operations.

• Knowledge of HEDIS, Quality Management programs, population health, delegated oversight, and performance improvement initiatives.

• Strong background in data analysis.

• Solid foundation in population health.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program in addition to base pay.